Premium
Influence of induction of anaesthesia on intubating conditions one minute after rocuronium administration: comparison of ketamine and thiopentone
Author(s) -
Hans P.,
Brichant J. F.,
Hubert B.,
Dewandre P. Y.,
Lamy M.
Publication year - 1999
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.1999.00703.x
Subject(s) - medicine , rocuronium , anesthesia , ketamine , premedication , intubation , midazolam , muscle relaxation , propofol , neuromuscular transmission , rocuronium bromide , tracheal intubation , adductor pollicis muscle , general anaesthesia , surgery , sedation , ulnar nerve , elbow
We compared the effect of thiopentone and ketamine on intubating conditions after rocuronium 0.6 mgkg −1 in two groups of patients ( n = 16 each), aged 21–44 years, undergoing elective surgery. Premedication consisted of alprazolam 1 mg by mouth 1 h before surgery. All patients received midazolam 2 mg intravenously 2 min before intravenous administration of thiopentone 5 mgkg −1 or ketamine 2.5 mgkg −1 . Muscle relaxation was provided by rocuronium 0.6 mgkg −1 . One minute after rocuronium administration, tracheal intubation was performed within 15 s by a skilled anaesthetist blinded to the treatment group assignment. Intubating conditions were graded as excellent, good, fair or poor on the basis of jaw relaxation, position of vocal cords and diaphragmatic response. Neuromuscular transmission was assessed at the adductor pollicis muscle using a TOF‐GUARD ™ monitor. Excellent and good intubating conditions were obtained in 100% of patients in the ketamine group and in 50% of patients in the thiopentone group (p = 0.002). Jaw relaxation was similar in both groups but vocal cord conditions were better and the diaphragmatic response less marked in the ketamine group compared with the thiopentone group (p = 0.002). The degree of neuromuscular block [% decrease of T1, mean (SD)] at the time of intubation was similar: 51.8 (25)% (ketamine group) and 54.3 (23.1)% (thiopentone group). We conclude that ketamine 2.5 mgkg −1 provides better intubating conditions than thiopentone 5 mgkg −1 1 min after administration of rocuronium 0.6 mgkg −1 .