Comparison of intubating conditions with propofol suxamethonium versus propofol-LIDOCAINE

Suxamethonium is a depolarising muscle relaxant that provides rapid, excellent intubating condition and ease of intubation. Its adverse effects has led to the search for comparable alternatives. Propofol alone provides fair intubating conditions and ease of tracheal intubation. Addition of intravenous lidocaine to propofol has been reported to enhance intubating conditions. The study compared the intubating conditions and ease of tracheal intubation following intravenous administration of propofol and suxamethonium (PS) with propofol and lidocaine (PL). The study was carried out in the department of Anaesthesia of the University of Benin Teaching Hospital, Benin City, Edo state, Nigeria. This is a prospective randomized double-blinded controlled study. Ethical approval was obtained from the University of Benin Ethics and Research committee. Eighty-eight eligible patients, aged 18-45 years, were prospectively randomized to 2 groups, PS and PL. Group PS received 2mg/kg propofol and 1.5mg/kg suxamethonium. Group PL had 2mg/kg propofol and 1.5mg/kg intravenous lidocaine. Intubating condition was determined, using a scale of 0 - 6 derived from jaw relaxation, ease of intubation and reflex response to intubation. Intubating condition was scored as good = 5-6, moderate = 3-4 and poor = 0-2. The propofol-suxamethonium (PS) group had 100% good intubating condition and successful intubation. The propofol-lidocaine (PL) group had 59.1% moderate and 11.3% poor intubating conditions, with 70.5% successful and 29.5% failed intubation rates respectively. Laryngoscopy and endotracheal intubation are possible with appropriate doses of propofol and lidocaine, without the use of suxamethonium.