ORIGINAL ARTICLES

A comparative study between propofol-fentanyl versus propofol-suxamethonium for ease of endotracheal intubation in children

Alfa Mikailu, Mamuda Atiku, Ahmad Abdurrahman, Dalhat Salahu, Saheed Adesope

Department of Anaesthesia, Aminu Kano Teaching Hospital, Kano, Nigeria

Correspondence Address:
Dr. Dalhat Salahu
Department of Anaesthesia, Aminu Kano Teaching Hospital, Kano Nigeria

Source of Support: None
Conflict of Interest: None

Background Following propofol induction, suxamethonium tremendously improves intubating conditions in children and has been the gold standard agent for this purpose. However, suxamethonium could be absolutely contraindicated in some patients. Fentanyl, a short acting opioid, has been investigated as a suitable alternative with varying results.

Aim and Objectives: This study compares the ease of tracheal intubation between propofol-suxamethonium (1.5 mg/kg) and propofol-fentanyl (3 mcg/kg) during general anaesthesia among children. Patients and Methods: In this double-blind randomised controlled study, 84 ASA I or II patients booked for elective surgery under general anaesthesia requiring tracheal intubation were randomised into two groups (F and S). Induction was with propofol 3 mg/kg over 30 s followed by either fentanyl 3 mcg/kg or suxamethonium 1.5 mg/kg. Two minutes later, there was an attempt at intubation and intubating conditions were assessed using Steyn’s modification of Helbo-Hansen’s score (ease of laryngoscopy, jaw relaxation, coughing, vocal cord position, and limb movement).

Materials and Methods: This was a cross-sectional study conducted among senior plastic surgery residents in southern Nigeria using a well-structured online questionnaire carried out over a 3-month period. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software program, version 25.0. Measures were taken to significantly minimise response, answer order, and other survey research errors/bias. A pilot study was done. Consent was obtained from all participants.

Results: All patients in both groups had successful intubation at the first attempt. Patients in group S (suxamethonium) had significantly better overall intubating conditions compared to those in group F (fentanyl) (p=0.0001), 85.7% in group S compared to 21.4% in group F had excellent intubation condition. None of the patients in the two groups demonstrated fair or poor intubation condition.

Conclusion: A combination of propofol-fentanyl can be used as an alternative to propofol-suxamethonium to ease intubation in paediatric patients.