Injection pain, intubating conditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with alfentanil

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Abstract
In a double‐blind study, propofol (P) 2–2. 5 mg‐kg‐1 preceded by saline (Sal) or alfentanil (A) 20–30 Hg kg‐1 was used for anaesthetic induction in 59 young patients of ASA physical class I or II, premedicated with oxycodone 0. 1 mg‐kg‐1 and atropine 0. 01 m. kg‐1 i. m. The patients were randomly allocated to one of the four groups: Group 1 Sal + P2. 5, Group 2 A20 + P2. 5, Group 3 A30 + P2. 5 and Group 4 A30 + P2. Pain on injection of propofol occurred in 67, 36 and 7% of the patients in the Sal + P2. 5, A20 + P2. 5 and A30 + P2 groups, respectively, but not at all in the A30 + P2. 5 group. Intubating conditions were assessed as good, moderate, poor or impossible on the basis of jaw relaxation, ease of insertion of the tube and coughing on intubation, each on a three‐point scale. In impossible cases, suxamethonium was used. In the Sal + P2. 5 group, the frequencies of good, moderate, poor and impossible intubating conditions were 0, 38, 8 and 54%, respectively. The corresponding figures in the A30 + P2. 5 group were 43, 46, 7 and 14% (P‐1 and propofol 2. 5 mg'kg“‘. It caused no pain on injection of propofol, offered satisfactory (good or moderate) intubating conditions in 79% of the patients and prevented the cardiovascular intubation response.