Intubation Following Thiopental-Succinylcholine or Sevoflurane-Nitrous Oxide Anesthesia for General Anesthesia in Elective Surgeries in Adults

We performed a double-blinded, prospective, randomized controlledtrial to compare intubating conditions facilitated by succinylcholineor sevoflurane. One hundred twenty patients were randomizedto receive either succinylcholine or sevoflurane for trachealintubation. For the Succinylcholine group, patients were inducedwith thiopental 5 mg kg -1 and tracheally intubatedafter administration of succinylcholine 1.5 mg kg -1 IV. Patients receiving sevoflurane took three vital capacitybreaths of 8% sevoflurane and 66% N2O in O2. At the loss ofeyelash reflex, ventilation was assisted to establish end-tidalCO2 between 25-30 mm Hg, and intubation was performed. Criteria ofjaw relaxation, vocal cords positionand intubating responsewere used to assess intubation condition. If the intubationscore was 6 of 12, it was described as acceptable; otherwiseit was described as an unacceptable intubation condition. Trachealintubation was successful in all patients. The study was intubator and observerblinded with reference to patient group and they judged that four patients (6.7%)in the Sevoflurane group and only one patient (1.7%) in theSuccinylcholine group had an unacceptable intubation condition.However, there was no significant difference between groups(P > 0.05). Therefore, the three vital capacity breaths inhalationtechnique with sevoflurane may be an alternative for endotrachealintubation in adults. Implications: The three vital capacity inhaled anesthetic techniqueswith 8% sevoflurane and 66% N2O in O2 may be an alternative for endotracheal intubationin adults who are at high risk from succinylcholine.