Assessment of the Effectiveness and Safety of Endotracheal Intubation for Inhalational Anesthesia without the Use of Muscle Relaxants or Analgesics in Adults

Background: Tracheal intubation is achieved with drugs given for the induction of general anesthesia. This process is facilitated by administering a muscle relaxant. However, administration of muscle relaxants may be associated with side effects. The necessity to avoid the use of muscle relaxants becomes imperative in patients who are allergic to neuromuscular relaxants, or with difficult airway. The rationale for tracheal intubation without muscle relaxants may not be obvious to many health care providers in adults. Avoiding muscle relaxants can prevent the potential complications of their use and a faster return of spontaneous ventilation may be evidenced. Anesthesia inducction with gas may be an alternative to a safe and efficient orotracheal intubation without muscle relaxants and analgesic drugs. The aim of this study was to identify complications and evaluate the efficacy of pure inhalational anesthesia induction to achieve endotracheal intubation without the use of muscle relaxant and analgesic drugs. Methods: Prospective and randomiced study in 91 patients. Anesthesia induction was performed, without analgesics and muscle relaxants. The optimal intubation conditions were considered when the laryngoscopy showed the glottis completely open. Results: Orotracheal intubation was performed in 100%. The mean time lapsed until optimal conditions for intubation were achieved was 6 ± 0.88 minutes. The mean sevoflurane end-tidal volume at which intubation could be performed was 5.5% ± 0.26%.Transitory apnea in 57.1%, and apnea in 1.1%. Nausea and vomiting was 6.6%