{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:53:51Z","timestamp":1785401631558,"version":"3.56.0"},"reference-count":53,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T00:00:00Z","timestamp":1708819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    There is increasing interest in the use of short\u2010acting opioids such as remifentanil to facilitate tracheal intubation. The aim of this systematic review was to determine the efficacy and safety of remifentanil for tracheal intubation compared with neuromuscular blocking drugs in adult patients. We conducted a systematic search for randomised controlled trials evaluating remifentanil for tracheal intubation. Primary outcomes included tracheal intubation conditions and adverse events. Twenty\u2010one studies evaluating 1945 participants were included in the analysis. Use of remifentanil (1.5\u20134.0\u2009\u03bcg.kg\n                    <jats:sup>\u20101<\/jats:sup>\n                    ) showed no evidence of a difference in tracheal intubation success rate compared with neuromuscular blocking drugs (risk ratio (95%CI) 0.97 (0.94\u20131.01); six studies; 1232 participants; I\n                    <jats:sup>2<\/jats:sup>\n                    28%; p\u2009=\u20090.16; moderate\u2010certainty evidence). Compared with neuromuscular blocking drugs, the use of remifentanil (2.0\u20134.0\u2009\u03bcg.kg\n                    <jats:sup>\u20101<\/jats:sup>\n                    ) makes little to no difference in terms of producing excellent tracheal intubation conditions (risk ratio (95%CI) 1.16 (0.72\u20131.87); two studies; 121 participants; I\n                    <jats:sup>2<\/jats:sup>\n                    31%, p\u2009=\u20090.54; moderate\u2010certainty of evidence). There was no evidence of an effect between remifentanil (2.0\u20134.0\u2009\u03bcg.kg\n                    <jats:sup>\u20101<\/jats:sup>\n                    ) and neuromuscular blocking drugs for bradycardia (risk ratio (95%CI) 0.44 (0.01\u201313.90); two studies; 997 participants; I\n                    <jats:sup>2<\/jats:sup>\n                    81%; p\u2009=\u20090.64) and hypotension (risk ratio (95%CI) 1.05 (0.44\u20132.49); three studies; 1071 participants; I\n                    <jats:sup>2<\/jats:sup>\n                    92%; p\u2009=\u20090.92). However, the evidence for these two outcomes was judged to be of very low\u2010certainty. We conclude that remifentanil may be used as an alternative drug for tracheal intubation in cases where neuromuscular blocking drugs are best avoided, but more studies are required to evaluate the haemodynamic adverse events of remifentanil at different doses.\n                  <\/jats:p>","DOI":"10.1111\/anae.16255","type":"journal-article","created":{"date-parts":[[2024,2,25]],"date-time":"2024-02-25T22:34:24Z","timestamp":1708900464000},"page":"759-769","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Remifentanil for tracheal intubation without neuromuscular blocking drugs in adult patients: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"79","author":[{"given":"L.","family":"Santos","sequence":"first","affiliation":[{"name":"Dental Anaesthesia University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Zheng","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Singhal","sequence":"additional","affiliation":[{"name":"Dental Public Health University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Wong","sequence":"additional","affiliation":[{"name":"Dental Anaesthesia University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janh.2018.07.003"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2018.11.002"},{"key":"e_1_2_6_4_1","first-page":"622","article-title":"Residual neuromuscular block after rocuronium or cisatracurium","volume":"55","author":"Morais BS","year":"2005","journal-title":"Revista Brasileira de Anestesiologia"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu313"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.04.014"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/kjm2.12153"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.1727"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43678-023-00487-1"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer504"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-023-02296-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199806000-00007"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200110000-00028"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199311000-00005"},{"key":"e_1_2_6_15_1","unstructured":"Insys Development Company Inc.Naloxone for treatment of opioid overdose. 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