Comparative study of intubating conditions at the first minute with suxamethonium, rocuronium and different priming techniques of rocuronium.
OBJECTIVE
To evaluate orotracheal intubation conditions after 1 min.


METHODS
A prospective randomized study with 376 adult American Society of Anesthesiologists (ASA) Grade I-III patients. Each patient received propofol, fentanyl and either suxamethonium (1 mg kg(-1)) or rocuronium. The intubating dose of rocuronium (2 x ED95) was preceded 4 min earlier by saline, or a 0.1 x ED95 priming dose of rocuronium, atracurium, cis-atracurium, vecuronium or mivacurium. Intubating conditions were graded as excellent, good or poor with respect to laryngoscopy, vocal cord position and movement and reaction to intubation and/or cuff inflation.


RESULTS
There were significant differences (P < 0.05) in laryngoscopy between suxamethonium and rocuronium primed with saline, atracurium or cis-atracurium. With respect to vocal cord position and movement during intubation, rocuronium without priming differed significantly from all other groups and for reaction to insertion of tracheal tube and/or cuff inflation. Rocuronium without priming differed significantly from all other groups except for rocuronium primed with itself. The mivacurium group showed more signs of pre-curarization than other groups (P < 0.05). There were significant differences between rocuronium alone and the other groups when final intubating conditions were compared.


CONCLUSIONS
Priming rocuronium with 0.1 x ED95 of vecuronium, rocuronium, atracurium or cis-atracurium is a safe technique and did not increase risk of pre-curarization in healthy patients.
Ortiz-Gómez
J R
JR
University Clinic, Department of Anesthesiology and Intensive Care, Navarra, Spain. jortizg@unav.es
Carrascosa
F
F
Pérez-Cajaraville
J J
JJ
Percaz-Bados
J A
JA
Añez
C
C
D000759:Adjuvants, Anesthesia; D000328:Adult; D000368:Aged; D000732:Androstanols; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D001279:Atracurium; D003371:Cough / Q000139:chemically induced; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl; D006801:Humans; D007442:Intubation, Intratracheal; D007546:Isoquinolines; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D000077590:Mivacurium; D016343:Monitoring, Intraoperative; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D015742:Propofol; D011446:Prospective Studies; D000077123:Rocuronium; D013390:Succinylcholine; D014827:Vocal Cords / Q000187:drug effects / Q000502:physiology
D000759:Adjuvants, Anesthesia; D000732:Androstanols; D018686:Anesthetics, Intravenous; D007546:Isoquinolines; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D000077590:Mivacurium; D013390:Succinylcholine; D005283:Fentanyl; D000077123:Rocuronium; D015742:Propofol