Rapid-sequence orotracheal intubation: a comparison of three techniques.
The authors compared tracheal intubating conditions using three techniques for rapid-sequence orotracheal intubation. Sixty patients were randomly assigned to one of three groups: priming with vecuronium (0.01 mg/kg priming dose, 4-min priming interval, 0.14-mg/kg intubating dose along with thiopental 4-6 mg iv); timing with vecuronium (0.15-mg/kg intubating dose given before thiopental and timed to weakness of hand grip); and succinylcholine (1.5 mg/kg). Blinded intubators graded intubating conditions 60 s after the induction of anesthesia with thiopental. Intubation scores in the succinylcholine group were significantly better than in the priming group (P = 0.009). Intubation scores of the succinylcholine and the timing groups were not significantly different. Use of the timing principle for rapid-sequence orotracheal intubation is a reliable alternative in cases where succinylcholine is contraindicated.
Silverman
S M
SM
Department of Anesthesia, Brooke Army Medical Center, Fort Sam Houston, Texas.
Culling
R D
RD
Middaugh
R E
RE
D000005:Abdomen / Q000502:physiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D003371:Cough; D004558:Electric Stimulation; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D008874:Midazolam; D008875:Middle Aged; D009132:Muscles / Q000187:drug effects / Q000502:physiology; D011229:Preanesthetic Medication; D011897:Random Allocation; D016037:Single-Blind Method; D013390:Succinylcholine / Q000008:administration & dosage*; D013874:Thiopental / Q000008:administration & dosage; D013997:Time Factors; D014673:Vecuronium Bromide / Q000008:administration & dosage*
D014673:Vecuronium Bromide; D013390:Succinylcholine; D013874:Thiopental; D008874:Midazolam