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The intubating laryngeal mask airway: rocuronium improves endotracheal intubating conditions and success rate.

Abstract：

STUDY OBJECTIVE:To assess intubating conditions without neuromuscular blocking drugs, to determine the relation between the dose of rocuronium and the probability of achieving excellent or at least good (good or excellent) intubating conditions with the intubating laryngeal mask airway (ILMA), and finally, to determine the relationship between rocuronium use and the success rate of endotracheal intubation. DESIGN:Prospective, randomized, double-blinded, placebo-controlled study. SETTING:University-affiliated medical center. PATIENTS:Sixty American Society of Anesthesiologists physical status I and II patients undergoing elective surgery. INTERVENTIONS:Anesthesia was induced with propofol 2.5 mg/kg and fentanyl 1 microg/kg. One minute after loss of consciousness, patients received rocuronium 0.2 mg/kg or saline. In the rocuronium group, if intubating conditions were scored as poor, rocuronium dose in the next patient was increased by 0.05 mg/kg. If intubating conditions were scored as good, no change was made, but if conditions were scored as excellent, the dose was decreased by 0.05 mg/kg. One minute after rocuronium or saline administration, an ILMA was used to intubate the trachea. If intubation was unsuccessful, a second attempt was made using the ILMA. MEASUREMENTS:We recorded intubating conditions and the success rate of tracheal intubation. MAIN RESULTS:Without rocuronium, the probability of achieving at least good intubating conditions with the ILMA was 30%. A rocuronium dose of 0.2 mg/kg resulted in a probability of 80% to achieve at least good intubating conditions. Rocuronium significantly increased the success rate of the second intubation attempt. CONCLUSION:To achieve good or excellent intubating conditions with the ILMA, a rocuronium dose lower than the standard intubating dose of 0.6 mg/kg can be used. Neuromuscular blockade increases the success rate of intubation if a second attempt is necessary.

journal_name

J Clin Anesth

journal_title

Journal of clinical anesthesia

authors

Sastry SG,Lemmens HJ

doi

10.1016/j.jclinane.2004.06.009

subject

Has Abstract

pub_date

2005-05-01 00:00:00

pages

163-6

issue

3

eissn

0952-8180

issn

1873-4529

pii

S0952-8180(05)00011-5

journal_volume

17

pub_type

临床试验,杂志文章,随机对照试验

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