Effects of Tracheal Intubation Without Muscle Relaxants on Postoperative Recovery Conditions in Patients With Obstructive Sleep Apnea: a Double-Blind Randomized Controlled Study

Abstract

Aim: We aimed to compare intubation with and without neuromuscular blocking agents with regard to intubation success,hemodynamic parameters, and postoperative recovery in Obstructive sleep apnea patients.Materials and Methods: The study included 60 patients with a STOP-Bang (Snoring, Tiredness during daytime, Observed apnea,high blood Pressure, Body mass index, Age, Neck circumference, Gender) score of ≥3. The patients were randomly divided into twogroups: (I) rocuronium group (Group E) and (II) remifentanil group (Group R). Group R received 4 mcg/kg remifentanil and Group Ereceived 0.6 mg/kg rocuronium and then the patients’ intubation difficulty scale scores and their responses to train-of-four (TOF)nerve stimulation, and postoperative recovery were evaluated in both groups.Results: The median time to recovery of the TOF ratio to 0 following anesthetic induction was significantly higher in Group Rcompared to Group E (p<0.001). The overall incidences of postoperative sore throat and hoarseness were remarkably high (p<0.002and p<0.001, respectively). The numbers of patients with relaxed vocal cords and complete jaw relaxation were significantly higherin Group E compared to Group R (p<0.001).Conclusion: The results indicated that rocuronium provides better intubation conditions and leads to less peri- and post-operativecomplications compared to remifentanil.