Effects of Remifentanil and Propofol on Elective Tracheal Intubation in Laparoscopic Surgery with or without Muscle Relaxant: A Comparative Study

Open Access

Abstract

Background: Endotracheal intubation is routinely required in laparoscopic surgery due to increased aspiration risk and reduced respiratory compliance. This study compares intubating conditions and postoperative myalgia between remifentanil-propofol and remifentanil-propofol with suxamethonium. Objective: The aim of the study was to compare the effects of remifentanil and propofol with or without muscle relaxant on intubation and hemodynamic responses in elective laparoscopic surgery. Methods & Materials: This quasiexperimental study was conducted in the Reproductive Endocrinology and Infertility operation theatre under the Department of Anaesthesia, Analgesia and Intensive Care Medicine, Bangladesh Medical University, Dhaka (October 2024-September 2025), involving 64 laparoscopic surgery patients equally allocated to Group PR (remifentanil-propofol) and Group PRS (remifentanil-propofol-suxamethonium); intubation was assessed by Steyn's Helbo-Hansen score, hemodynamics at baseline and 1, 5, and 10 minutes, postoperative myalgia at 24 hours, and data analyzed with SPSS v26. Results: Baseline demographic and clinical characteristics were comparable between Group PR and Group PRS (p > 0.05). Intubating conditions, intubating scores, and hemodynamic parameters at different time intervals showed no statistically significant differences between the groups. However, postoperative myalgia score (0.38 ± 0.49 vs 0.81 ± 0.54; p = 0.001) and incidence of myalgia [12 (37.5%) vs 24 (75.0%); p = 0.007] were significantly lower in Group PR compared to Group PRS. Conclusion: Remifentanil and propofol provide comparable intubating conditions and haemodynamic stability to suxamethonium-containing regimens while reducing postoperative myalgia.