TEACHING FIBEROPTIC INTUBATION - EFFECT OF ALFENTANIL ON THE HEMODYNAMIC-RESPONSE

A technique for teaching fibreoptic orotracheal intubation in patients under general anaesthesia is described and evaluated. A standard general anaesthetic was administered to 60 patients presenting for elective gynaecological surgery. Patients were randomly assigned to receive either alfentanil 10 μg. Kg−1 or a placebo, and to be intubated either by a consultant experienced in the use of the fibreoptic bronchoscope or by an inexperienced trainee under instruction. Heart rate, arterial pressure and oxygen saturation were monitored continuously. The time to achieve tracheal intubation in the trainee group was significantly prolonged (p < 0.001), but no patient developed arterial desaturation. The hypertensive response to fibreoptic intubation was suppresed in those patients who received alfentanil (p < 0.001). The increase in heart rate was not suppressed, but was attenuated when these patients were compared with those who had received the placebo (p < 0.001). Alfentanil 10μ.kg−1 minimises the haemodynamic response when teaching fibreoptic orotracheal intubation under general anaesthesia. Copyright © 1994, Wiley Blackwell. All rights reserved