Anaesthesia for direct laryngoscopy with propofol and fentanyl or sufentanil

AIM #ENTITYSTARTX00026;

To find if direct laryngoscopy (DL) could be done without using succinylcholine and secondly, to acertain the appropriate anesthetic regimen.

In a double blind placebo controlled study 67 patients aged 40-75 years of age, of both sex requiring direct laryngoscopy (DL) either for diagnosis or for biopsy were enrolled. The patients were randomly divided in three groups. The patients in group F and S received Fentanyl or Sufentanil respectively along with Propofol, whereas those in group N received normal saline (placebo) and propofol. The conditions of laryngoscopy, hemodynamic parameters and any adverse events were recorded. Good or fair conditions for laryngoscopy were achieved in 91% (21), 87% (19) and 73% (16) of patients in groups F, S and N respectively (p < 0.05) in favor of group F and S. During DL arterial pressure and pulse rate changes were minimal when propofol was administered along with opioids, (group F and S) compared to group N where only propofol was used.

No serious side effects were seen in the three groups. Hence by these findings we concluded that better conditions of DL are achieved during anesthesia with propofol and fentanyl and sufentanil alone. The opioids provided additional benefit of stable hemodynamics.