Early tracheal intubation with thiopentone in elective surgery.
We have studied tracheal intubating conditions within 30 s of administration of thiopentone in 24 patients and compared this with our usual method of tracheal intubation, which involves 3 min of manual ventilation in 29 patients. All patients received papaveretum 10 mg 3 min before induction and alcuronium at induction of anaesthesia. Satisfactory intubating conditions were observed in 83% of patients in both groups. There were no difficult or failed intubations and no patient had laryngospasm. The duration of laryngoscopy in the control group was 14.1 (SD 8.6) s (range 7-50 s), compared with 12.4 (3.1) s (range 6-20 s), in the early intubation group (ns). In the control group there was a significant decrease in systolic pressure before tracheal intubation and a significant increase in heart rate after intubation, compared with baseline values. The average systolic pressure in the early intubation group increased only minimally: from a pre-intubation value of 143.3 (21.2) mm Hg to 145.5 (25.1) mm Hg after intubation. Our results demonstrate that early tracheal intubation under thiopentone supplemented with an opioid and a non-depolarizing neuromuscular block is feasible, associated with minimal changes in arterial pressure and not accompanied by an increased incidence of side effects.
Marsh
J E
JE
Department of Anaesthetics, University of Natal, Congella, Durban, S. Africa.
Murray
W B
WB
Rocke
D A
DA
D000328:Adult; D000443:Alcuronium; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D011897:Random Allocation; D013514:Surgical Procedures, Operative; D013874:Thiopental / Q000008:administration & dosage*; D013997:Time Factors
D013874:Thiopental; D000443:Alcuronium