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Does the Timing of Tracheal Intubation Based on Neuromuscular Monitoring Decrease Laryngeal Injury? Similar Method, Similar Conditions, Conflicting Results

Mencke, Thomas, MD; Noeldge-Schomburg, Gabriele, MD; Soltesz, Stefan, MD

Section Editor(s): Shafer, Steven L.

doi: 10.1213/01.ane.0000247708.72463.4b
Letters to the Editor: Letters & Announcements
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Department of Anaesthesia and Intensive Care Medicine, University of Rostock, Rostock, Germany, thomas.mencke@uni-rostock.de or thomas.mencke@googlemail.com (Mencke, Noeldge-Schomburg)

Department of Anaesthesia and Intensive Care Medicine, Hospital of Leverkusen, Leverkusen, Germany (Soltesz)

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In Response:

As pointed out by Drs. Slehofer and Leone (1), our two recent studies (2,3) produced conflicting incidences for vocal cord injuries. We maintained anesthesia in the first study with fentanyl and desflurane, while in the second study we maintained anesthesia with remifentanil and propofol. Maruyama et al. (4) studied 418 patients after total IV anesthesia and found sore throat in 50% and hoarseness in 55% of the patients, which they attributed to the lack of muscle relaxation provided by propofol. Perhaps that explains the increased incidence of vocal cord injuries in our second study, a variable we will examine in future studies.

Thomas Mencke, MD

Gabriele Noeldge-Schomburg, MD

Department of Anaesthesia and Intensive Care Medicine

University of Rostock

Rostock, Germany

thomas.mencke@uni-rostock.de or thomas.mencke@googlemail.com

Stefan Soltesz, MD

Department of Anaesthesia and Intensive Care Medicine

Hospital of Leverkusen

Leverkusen, Germany

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REFERENCES

1. Slehofer G, Leone M. Does the timing of tracheal intubation based on neuromuscular monitoring decrease laryngeal injury? Similar method, similar conditions, conflicting results. Anesth Analg 2007;104:211.
2. Mencke T, Echternach M, Plinkert PK, et al. Does the timing of tracheal intubation based on neuromuscular monitoring decrease laryngeal injury? A randomized, prospective, controlled trial. Anesth Analg 2006;102:306–12.
3. Mencke T, Echternach M, Kleinschmidt S, et al. Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial. Anesthesiology 2003;98:1049–56.
4. Maruyama K, Sakai H, Miyazawa H, et al. Sore throat and hoarseness after total intravenous anesthesia. Br J Anaesth 2004;92:541–3.
© 2007 International Anesthesia Research Society