British Journal of Anaesthesia, Vol 77, Issue 3 339-342, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
H. J. Sparr, S. Giesinger, H. Ulmer, M. Hollenstein-Zacke and T. J. Luger
We have assessed the effect of anaesthetic technique on intubating
conditions after rocuronium 0.6 mg kg-1 in four groups (n = 25 each) of
unpremedicated patients in whom anaesthesia was induced with either
thiopentone 5 mg kg-1 or propofol 2.5 mg kg-1 alone, or supplemented with
alfentanil 20 micrograms kg-1. Fifty control patients were anaesthetized
with thiopentone followed by suxamethonium. Laryngoscopy was commenced at
45 s. Overall intubating conditions after rocuronium were similar to those
after suxamethonium (good and excellent > or = 96%) only when alfentanil
was part of the induction regimen. However, intubation time was similar in
all five groups and averaged 55 (SD 3.2) s, and the tube could be passed
through open vocal cords within 70 s. After rocuronium the response of the
diaphragm to intubation was more pronounced in the two groups of patients
not receiving alfentanil (P < 0.0001) and in patients anaesthetized
using propofol with alfentanil (P < 0.01) than in the control group.
Opioids (in doses equivalent to alfentanil 20 micrograms kg-1) constitute
an integral part of an induction regimen containing rocuronium 0.6 mg kg-1,
regardless of whether or not thiopentone or propofol is used, in order to
achieve overall intubating conditions similar to those after suxamethonium.
CLINICAL INVESTIGATIONS
Influence of induction technique on intubating conditions after rocuronium in adults: comparison with rapid-sequence induction using thiopentone and suxamethonium
Department of Anaesthesia and Intensive Care Medicine, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria; Department of Biostatistics, University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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