Observational Study on the Effect of Propofol and Remifentanil Using Modified Topical Anaesthesia Method

Jiajia Jiang, Guojiang Yin, Hong Wang and Guosheng Gan

Background and Objectives: Topical anaesthesia (TA) is defined as blocking the nerve conduction which is reversibly surrounding the site of application. In this study, we observed the beneficial effect between propofol and remifentanil using modified topical anaesthesia. Materials and Methods: A total of 936 patients were categorized into three groups in the ratio of 1:1:1 (312:312:312) and classified based on ASA grading. The three groups were administered with propofol (Group-I), remifentanil (Group-II) and propofol-remifentanil cocktail (Group-III) and proceeded for a modified Awake Fiberoptic Intubation (AFOI) and evaluated for airway assessment and clinical outcome. Results: No statistically significant difference was observed based on the coughing and limb motion scores. The mean time for tracheal intubation was 589.3±5.7 sec for Group-I compared to 581.2±4.5 sec for Group-II and 603.7±3.9 sec for Group-III. Fourteen patients (4.49%) of Group-I were observed with severe airway obstruction scores compared to 8 patients (2.56%) of Group-II and 11 patients (3.53%) of Group-III. Group-II patients also scored favourable postoperative episodes without any issues and complicacy. Overall Group-II patients (remifentanil) attained satisfactory and successful airway management compared to Group-I and Group-III patients. Conclusion: The study concludes that the infusion of remifentanil with modified topical anaesthesia resulted in more successful and satisfactory airway management and intubating conditions compared to propofol.

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