Objective: The object of this study was whether the intubating conditions and the haemodynamic responses to intubation and laryngoscopy without neuromuscular block were better as compared to that, following suxamethonium. Material and Methods: A prospective study was conducted on patients who were undergoing Adeno Tosillectomy. This study was performed Khyber Teaching Hospital, Peshawar over a period of one year (1995 to 1996). 100 patients of both sexes were selected which were undergoing adenotonsillectomy. Their ages were between 8 to 12 years. The patients with potentially difficult intubation and those who were sensitive to the drugs used were excluded from the study. Patients were divided in two groups of 50 patients each. In group-A induction was done with propofol and suxamethonium and in group-B induction was achieved with propofol and fentanyl. Results: After collecting and comparing the data in both the groups the result showed no statistically significant difference in the two groups except limb movements and coughing. In group A (suxamethonium) 99% cases had acceptable intubation and Laryngoscopy while the conditions were unacceptable in 1 % cases. There was a slight cough in 10% cases and slight limb movements in 15% cases while in group B (fentanyl) 87% cases had acceptable intubation and Laryngoscopy while 13% had unacceptable intubating condition. Severe cough was present in 5% cases while moderate limb movements were present in 20% cases. As far as haemodynamic variables were concerned heart rate and MAP shooted. High in group A while in group B there was slight decrease in both the variables. Conclusion: Intubation with fentanyl and propofol has the advantage of less haemodynamic changes and attenuation of physiological responses to endotracheal intubation. Side effects of suxamethonium are also avoided. These studies need further evaluation concerning the doses of different agents and their proper timing. It is hoped that in future that we might get rid of the bad aspects of the drugs used in group B (fentanyl-propofol) like coughing, limb movements, high cost and non-availability of the product in market.
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