Comparison of remifentanil with alfentanil or suxamethonium following propofol anaesthesia for tracheal intubation

Sixty ASA physical status I and II, premedicated patients were administered propofol 2.mg.kg(-1) and remifentanil 2 mu g.kg(-1) (group R), alfentanil 50 mu g.kg(-1) (group A) or suxamethonium 1 mg.kg(-1) (group S) as a rapid bolus. One minute after study drug administration, tracheal intubation was performed. Intubation conditions piece then scared. Excellent or good conditions were observed in only 35% in group R compared with groups S and A (100% and 85%, respectively; p < 0.001). The haemodynamic response to tracheal intubation was blunted in groups R and A compared with group S (p < 0.001). The mean heart rate in groups R and A was significantly lower than group S (p < 0.001). We conclude that remifentanil 2 mu g.kg(-1) given as a rapid bolus will not: produce intubating conditions as good as those obtained with alfentanil 50 mu g.kg(-1) or suxamethonium 1 mg.kg(-1) if administered after propofol 2 mg.kg(-1).