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Comparison of intubating conditions after rocuronium and suxamethonium following “rapid‐sequence induction” with thiopentone in elective cases
Author(s) -
Sparr H. J.,
Luger T. J.,
Heidegger T.,
PutensenHimmer G.
Publication year - 1996
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1996.tb04464.x
Subject(s) - medicine , rapid sequence induction , rocuronium , anesthesia , sequence (biology) , intubation , genetics , biology
Background : Rocuronium (Org 9426) was shown to have the fastest onset of action of all currently available non‐depolarizing neuromuscular blocking drugs and to provide intubating conditions similar to those of suxamethonium 60 to 90 s after administration. We compared the intubating conditions after rocuronium and suxamethonium following rapid‐sequence induction of anaesthesia. Methods : Fifty unpremedicated patients of ASA physical status I or II, scheduled for elective surgery were studied. Anaesthesia was induced with thiopentone 6 mg kg ‐1 followed randomly by suxamethonium 1 mg kg ‐1 or rocuronium 0.6 mg kg ‐1 and, 45 s later, intubation was commenced. Muscle fasciculations, intubating conditions and intubation time, haemodynamic variables and oxygenation were assessed. Results : Intubation time did not differ between suxamethonium (9.8±2.2 s) (mean±SD) and rocuronium (10.5±2.9 s), respectively. Intubating conditions were clinically acceptable (good or excellent) in all patients given suxamethonium and in 96% of the patients given rocuronium. However, the condition of the vocal cords was better (P<0.05) and diaphragmatic response to intubation was less pronounced with suxamethonium (P<0.05). Changes in heart rate and arterial blood pressure were similar in both groups. Conclusion : The authors conclude that rocuronium is a suitable alternative to suxamethonium for rapid tracheal intubation even under unsupplemented thiopentone anaesthesia, at least in elective, otherwise healthy patients. Its use for rapid‐sequence induction under emergency conditions, however, needs further investigation.