Intubation without muscle relaxation for suspension laryngoscopy: A randomized, controlled study

Abstract

Objective and Aim: The objective of the following study is to examine the effectiveness and safety of suspension laryngoscopy under intubation with propofol and remifentanil alone for vocal fold nodule (VFN) excision.
Materials and Methods: A total of 40 patients were equally and randomly assigned to elective VFN excision using suspension laryngoscopy under intubation with propofol and remifentanil alone (Group A) or with  supplementary cisatracurium (Group B).
Results: Intubation time was significantly longer in Group A than in Group B (300.0 } 30.0 s vs. 265.2 } 38.7 s, P = 0.003). The two groups showed similar Cormack.Lehane classifications, intubation conditions and ease of
suspension laryngoscopy. Both groups showed favorable cardiopulmonary safety profiles. Post.anesthesia recovery was significantly more rapid in Group A than in Group B, in terms of times to spontaneous breathing return (7.2 } 1.4 min vs. 10.9 } 1.6 min, P < 0.001), consciousness return (7.4 } 1.5 min vs. 12.3 } 1.8 min, P < 0.001), removal of tracheal intubation (8.1 } 1.5 min vs. 13.2 } 1.7 min, P < 0.001) and operating room discharge (12.7 } 1.4 min vs. 22.1 } 1.3 min, P < 0.001).
Conclusion: Use of propofol and remifentanil alone provides favorable intubation and anesthesia conditions for suspension laryngoscopic VFN excision and accelerates post.anesthesia recovery.

Key words: Endotracheal intubation, muscle relaxant, propofol,  randomized controlled study, remifentanil, suspension laryngoscopy, vocal fold nodule