Skip Navigation



BJA Advance Access published online on April 2, 2007
British Journal of Anaesthesia, doi:10.1093/bja/aem064
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
98/5/604    most recent
aem064v1
Right arrow E-Letters: Submit a response to the article
Right arrow E-letters: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Abou-Arab, M. H.
Right arrow Articles by Caldwell, J. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Abou-Arab, M. H.
Right arrow Articles by Caldwell, J. E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Dose of alfentanil needed to obtain optimal intubation conditions during rapid-sequence induction of anaesthesia with thiopentone and rocuronium

M. H. Abou-Arab1, T. Heier1,* and J. E. Caldwell2

1 Department of Anesthesia, Aker University Hospital, Oslo, Norway
2 Department of Anesthesia and Perioperative Care, UCSF, San Francisco, CA, USA

* Corresponding author: Department of Anesthesia, Aker University Hospital, Trondheimsvn 235, 0514 Oslo, Norway. E-mail: tom.heier{at}medisin.uio.no

Background: The primary aim of the present study was to determine the dose of alfentanil that must be added to a rapid-sequence induction (RSI) regimen using thiopentone and rocuronium to obtain optimal intubation conditions in >95% of the individuals.

Methods: A total of 60 ASA I patients were randomly allocated to five different alfentanil dose groups (0, 15, 30, 45, or 60 µg kg–1). A blinded dose of alfentanil followed by thiopentone 4 mg kg–1 and rocuronium 1 mg kg –1 was administered in rapid succession, and tracheal intubation was attempted 40 s thereafter. The relationship between the alfentanil dose and the probability of optimal intubation conditions was determined by non-linear logistic regression analysis. Blood pressure (BP) changes were recorded continuously using an intra-arterial catheter.

Results: The success rate of optimal intubation conditions increased with increasing doses of alfentanil. The alfentanil dose needed to obtain optimal intubation conditions in >95% of the patients was 36.4 (CI 33.4–39.4) µg kg–1. In 12 patients, the systolic BP declined to <90 mm Hg during the 3 min immediately after intubation.

Conclusion: Adding 36–40 µg kg–1 alfentanil to a regimen of thiopentone and rocuronium during RSI of anaesthesia may significantly increase the success rate of optimal intubation conditions. Significant hypotension requiring vasopressor treatment may occur.

Keywords: analgesics opioid, alfentanil; induction, anaesthesia; intubation, tracheal tube


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Br J AnaesthHome page
H. A. Mowafi, N. Aldossary, S. A. Ismail, and J. Alqahtani
Effect of dexmedetomidine premedication on the intraocular pressure changes after succinylcholine and intubation
Br. J. Anaesth., April 1, 2008; 100(4): 485 - 489.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
M. El-Orbany, M. H. Abou-Arab, T. Heier, and J. E. Caldwell
Opioids and rapid-sequence induction
Br. J. Anaesth., October 1, 2007; 99(4): 598 - 598.
[Full Text] [PDF]

E-letters:

Read all E-letters

Opioids and rapid-sequence induction
Mohammad El-Orbany
British Journal of Anaesthesia, 20 Jun 2007 [Full text]
Alfentanil and rocuronium during rapid-sequence induction of anaesthesia
tom heier
British Journal of Anaesthesia, 3 Jul 2007 [Full text]

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.