title: Thiopental-rocuronium versus ketamine-rocuronium for rapid-sequence intubation in parturients undergoing cesarean section.
abstract: We investigated the neuromuscular effects and conditions of tracheal intubation after administration of rocuronium in 40 parturients undergoing elective cesarean section. After preoxygenation, anesthesia was induced in 20 patients by thiopental 4 mg/kg and, in the other 20 patients, by ketamine 1.5 mg/kg. Rocuronium 0.6 mg/kg was then administered, and neuromuscular transmission was assessed using electromyographic response to train-of-four stimulation of the ulnar nerve at the wrist every 10 s. The time to T1/control ratio of 50% neuromuscular block (NMB) as well as the time to maximum NMB (onset time) were compared in the two groups. The time to 50% block was 45 +/- 10 s in the thiopental group and 42 +/- 14 s in the ketamine group, while the onset time was 105 +/- 35 s in the thiopental group and 101 +/- 35 s in the ketamine group. Neither the time to 50% NMB nor the onset time were significantly different between the two groups. Tracheal intubation at 50% NMB was easily performed in all patients in the ketamine-rocuronium group but was difficult in 75% of the thiopental-rocuronium group. We concluded that ketamine 1.5 mg/kg followed by rocuronium 0.6 mg/kg may be suitable for rapid-sequence induction of anesthesia in parturients undergoing cesarean section.
authors.affiliation: Department of Anesthesiology, American University of Beirut, Lebanon.
authors.forename: A S
authors.initials: AS
authors.lastname: Baraka
authors.forename: S S
authors.initials: SS
authors.lastname: Sayyid
authors.forename: B A
authors.initials: BA
authors.lastname: Assaf
mesh_terms: D000328:Adult; D000732:Androstanols / Q000008:administration & dosage*; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000777:Anesthetics / Q000008:administration & dosage*; D001034:Apgar Score; D002585:Cesarean Section; D004311:Double-Blind Method; D004576:Electromyography; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007649:Ketamine / Q000008:administration & dosage*; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D011247:Pregnancy; D000077123:Rocuronium; D013874:Thiopental / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D000732:Androstanols; D000777:Anesthetics; D003473:Neuromuscular Nondepolarizing Agents; D007649:Ketamine; D013874:Thiopental; D000077123:Rocuronium