title: Does the choice of intravenous induction drug affect intubation conditions after a fast-onset neuromuscular blocker?
abstract: OBJECTIVE
  To compare intubation conditions and hemodynamic effects resulting from thiopental-rapacuronium, propofol-rapacuronium, and etomidate-rapacuronium intravenous (IV) induction.
  
  
  METHODS
  Randomized, blinded study.
  
  
  METHODS
  Operating suites of a large university-affiliated medical center.
  
  
  METHODS
  60 ASA physical status I and II adult patients without airway abnormalities, who were scheduled for elective surgery requiring endotracheal intubation. Patients were randomly allocated to receive IV thiopental sodium 5 mg/kg (Group 1), propofol 2 mg/kg (Group 2), or etomidate 0.3 mg/kg (Group 3) followed by rapacuronium 1.5 mg/kg. Fifty seconds later, an anesthesiologist, who had no knowledge of the induction drug used, entered the operating room and attempted laryngoscopy and intubation.
  
  
  METHODS
  Intubation conditions were graded as excellent, good, poor, or impossible according to Good Clinical Research Practice criteria. Arterial blood pressure and heart rate changes accompanying both induction techniques were also monitored and recorded.
  
  
  RESULTS
  All patients were intubated within 55 to 70 seconds. Clinically acceptable intubation conditions were not statistically different among the three groups. Moderate tachycardia after induction was seen in all three groups, and blood pressure was significantly lower in Group 2 than in Groups 1 or 3.
  
  
  CONCLUSIONS
  Clinically acceptable intubation conditions are similar after either thiopental, propofol, or etomidate when a fast-onset neuromuscular blocking drug (rapacuronium 1.5 mg/kg) is used to facilitate tracheal intubation.
authors.affiliation: Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago 60657, USA.
authors.forename: Mohammad I
authors.initials: MI
authors.lastname: El-Orbany
authors.forename: Yaser
authors.initials: Y
authors.lastname: Wafai
authors.forename: Ninos J
authors.initials: NJ
authors.lastname: Joseph
authors.forename: M Ramez
authors.initials: MR
authors.lastname: Salem
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D001794:Blood Pressure / Q000502:physiology; D004311:Double-Blind Method; D005045:Etomidate; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents; D015742:Propofol; D013610:Tachycardia / Q000209:etiology / Q000503:physiopathology; D013874:Thiopental; D014673:Vecuronium Bromide / Q000031:analogs & derivatives*
chemical_list: D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D014673:Vecuronium Bromide; C082938:rapacuronium; D013874:Thiopental; D015742:Propofol; D005045:Etomidate