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Comparative study of intubating conditions at the first minute with suxamethonium, rocuronium and different priming techniques of rocuronium

Published online by Cambridge University Press:  29 April 2005

J. R. Ortiz-Gómez ,
F. Carrascosa ,
J. J. Pérez-Cajaraville ,
J. A. Percaz-Bados  and
C. Añez
J. R. Ortiz-Gómez
Affiliation:
University Clinic, Department of Anesthesiology and Intensive Care, Tarragona, Spain University of Navarra, School of Medicine, Department of Anesthesiology, Navarra, Spain Royal Academy of Medicine and Surgery of Valladolid, Valladolid, Spain
F. Carrascosa
Affiliation:
University Clinic, Department of Anesthesiology and Intensive Care, Tarragona, Spain University of Navarra, School of Medicine, Department of Anesthesiology, Navarra, Spain
J. J. Pérez-Cajaraville
Affiliation:
University Clinic, Department of Anesthesiology and Intensive Care, Tarragona, Spain
J. A. Percaz-Bados
Affiliation:
University Clinic, Department of Anesthesiology and Intensive Care, Tarragona, Spain
C. Añez
Affiliation:
Joan XXIII Hospital, Department of Anesthesiology, Tarragona, Spain
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Abstract

Summary

Background and objective: To evaluate orotracheal intubation conditions after 1 min.

Patients and methods: A prospective randomized study with 376 adult American Society of Anesthesiologists (ASA) Grade I–III patients. Each patient received propofol, fentanyl and either suxamethonium (1 mg kg−1) or rocuronium. The intubating dose of rocuronium (2 × ED95) was preceded 4 min earlier by saline, or a 0.1 × ED95 priming dose of rocuronium, atracurium, cis-atracurium, vecuronium or mivacurium. Intubating conditions were graded as excellent, good or poor with respect to laryngoscopy, vocal cord position and movement and reaction to intubation and/or cuff inflation.

Results: There were significant differences (P < 0.05) in laryngoscopy between suxamethonium and rocuronium primed with saline, atracurium or cis-atracurium. With respect to vocal cord position and movement during intubation, rocuronium without priming differed significantly from all other groups and for reaction to insertion of tracheal tube and/or cuff inflation. Rocuronium without priming differed significantly from all other groups except for rocuronium primed with itself. The mivacurium group showed more signs of pre-curarization than other groups (P < 0.05). There were significant differences between rocuronium alone and the other groups when final intubating conditions were compared.

Conclusions: Priming rocuronium with 0.1 × ED95 of vecuronium, rocuronium, atracurium or cis-atracurium is a safe technique and did not increase risk of pre-curarization in healthy patients.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolINTUBATION, INTRATRACHEALNEUROMUSCULAR NON-DEPOLARISING AGENTS, rocuronium, atracurium, vecuronium, cis-atracurium, mivacuriumNEUROMUSCULAR DEPOLARIZING AGENTS, succinylcholineNEUROMUSCULAR BLOCKADE, onset
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 4 , April 2005 , pp. 263 - 268
Copyright
2005 European Society of Anaesthesiology

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