当前位置： SCI文献检索 > JOURNAL OF CLINICAL ANESTHESIA期刊下所有文献 > Facilitation of rapid-sequence intubation with large-dose vecuronium with or without priming.

Facilitation of rapid-sequence intubation with large-dose vecuronium with or without priming.

Abstract：

STUDY OBJECTIVES:To determine the effect of priming on the intubation and onset times of vecuronium 0.3 mg/kg. DESIGN:Randomized, unblinded study. SETTING:Operating rooms and postanesthetic recovery unit of a university-affiliated general hospital. PATIENTS:Thirty female ASA physical status I and II patients scheduled for intraperitoneal surgery divided into two groups of 15 each. INTERVENTIONS:Anesthesia was induced and maintained with sufentanil, droperidol, thiopental sodium, and nitrous oxide in oxygen. Patients in Group 1 were given vecuronium 0.015 mg/kg 4 minutes before induction and vecuronium 0.285 mg/kg 1 minute after induction. Patients in Group 2 received a single 0.3 mg/kg dose of vecuronium 1 minute after thiopental sodium. The ulnar nerve was stimulated every 10 seconds with train-of-four supramaximal impulses of 0.2 millisecond duration at 2 Hz. The compound electromyogram (EMG) of the adductor pollicis was continuously recorded. The trachea was intubated when the amplitude of the EMG decreased to 15% to 25% of control. At the end of surgery, residual neuromuscular block was reversed with edrophonium 0.75 mg/kg. MEASUREMENTS AND MAIN RESULTS:All patients in Group 1 could be intubated in 80 seconds or less, and the longest onset time was 120 seconds. In Group 2, the longest intubation time was 140 seconds, and the longest onset time was 200 seconds. Clinical durations in both groups were unpredictable, ranging from 47 to 185 minutes in Group 1 and from 63 to 160 minutes in Group 2. Ten of the 30 patients required an additional 0.5 mg/kg of edrophonium for antagonism of the residual neuromuscular block. There were no significant changes in heart rate or blood pressure attributable to vecuronium. CONCLUSIONS:Seventy-five percent to 85% neuromuscular block of the adductor pollicis, required for atraumatic tracheal intubation, developed in 80 seconds or less when vecuronium 0.3 mg/kg was administered in divided doses and in 140 seconds or less when it was injected as a single bolus dose. Clinical duration of vecuronium 0.3 mg/kg is long and unpredictable, and reversal of residual neuromuscular block may require larger doses of anticholinesterases. It is recommended that an intubating dose of vecuronium 0.3 mg/kg be used only in patients undergoing long surgical procedures that require prolonged postanesthetic mechanical ventilation.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Deepika K,Bikhazi GB,Mikati HM,Namba M,Foldes FF

doi

10.1016/0952-8180(92)90024-u

subject

Has Abstract

pub_date

1992-03-01 00:00:00

pages

106-10

issue

eissn

0952-8180

issn

1873-4529

pii

0952-8180(92)90024-U

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

在线工具

Facilitation of rapid-sequence intubation with large-dose vecuronium with or without priming.