British Journal of Anaesthesia, Vol 80, Issue 4 504-506, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
T. Fuchs-Buder, H. J. Sparr and T. Ziegenfuss
We have assessed the effect of the choice of i.v. induction agent on
intubation conditions, 60 s after administration of rocuronium 0.6 mg kg-1.
We studied 60 adult patients, allocated randomly to one of two groups.
Anaesthesia was induced with alfentanil 10 micrograms kg-1 followed by
thiopental 5 mg kg-1 (AT-R group; n = 30) or etomidate 0.3 mg kg-1 (AE-R
group; n = 30). Both groups received rocuronium 0.6 mg kg- 1. Laryngoscopy
was started 60 s later and intubation conditions were evaluated according
to a standard score, which considered ease of laryngoscopy, condition of
the vocal cords and reaction to intubation. In the AT-R group, overall
intubation conditions were scored as excellent in 20 patients, good in nine
and fair in the remaining patient. In the AE-R group, overall intubating
conditions were excellent in 24 and good in six patients. The difference
between the two groups was not significant. Of the three components of the
intubation score assessed, response to intubation stimulus was
significantly less pronounced in group AE-R compared with group AT-R (P
< 0.05): group AE-R, no reaction in 24 patients, slight diaphragmatic
movement in five and mild coughing in one patient; group AT-R, no reaction
in 13, slight diaphragmatic movement in 14, mild coughing in two and severe
coughing in one patient. We conclude that etomidate as part of an induction
regimen containing alfentanil and rocuronium attenuated the reaction to
intubation to a greater extent than thiopental.
SHORT COMMUNICATIONS
Thiopental or etomidate for rapid sequence induction with rocuronium
Department of Anaesthesia and Intensive Care Medicine, University of Saarland, 66421 Homburg/Saar, Germany; Department of Anaesthesia and Intensive Care Medicine, University of Innsbruck, Innsbruck, Austria
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