Endotracheal Intubation Without Neuromuscular Blocking Agents: Is It a Good and Safe Option?

Dear Editor, We read with great interest the article, “Use of Remifentanil and Alfentanil in Endotracheal Intubation: A Comparative Study,” by Imani et al. (1). The authors demonstrated that remifentanil in combination with propofol provides excellent conditions for endotracheal intubation in young, healthy patients to avoid the use of muscle relaxants. However, there are some points about the article’s focus and results that we would like to discuss in this commentary. Propofol in combination with an opioid has been used by many investigators to facilitate neuromuscular blocking agent-free intubation.