title: Ketamine, but not priming, improves intubating conditions during a propofol-rocuronium induction.
abstract: OBJECTIVE
  Both ketamine and priming may shorten the onset time of rocuronium. This study investigates the effects of ketamine and priming as components of a propofol induction on intubating conditions and onset of neuromuscular block.
  
  
  METHODS
  This prospective randomized double-blind study was performed in 120 American Society of Anesthesiologists (ASA) I-II patients who were assigned to one of four groups of 30 patients each: control, priming, ketamine, and ketamine-priming. Ketamine 0.5 mg x kg(-1) or saline was given before priming and induction. Rocuronium 0.06 mg x kg(-1) or saline was injected 2 min before propofol 2.5 mg x kg(-1). This was followed by rocuronium 0.6 mg x kg(-1) or by rocuronium 0.54 mg x kg(-1) if priming was given. Intubation was performed one minute later. Intubating conditions were graded as excellent, good, or poor. Heart rate, noninvasive blood pressure, and train-of-four (TOF) response were monitored.
  
  
  RESULTS
  Intubating conditions were graded excellent in 20% of the control group, 30% of the priming group, 47% of the ketamine group, and 57% of the ketamine-priming group. Analysis using forward stepwise regression indicated that ketamine improved intubating conditions (P = 0.001) but priming did not (P = 0.35). Time to reach a TOF count of zero was shortened by ketamine (P = 0.001) but not by priming (P = 0.94): 216 +/- 20 s in the control group, 212 +/- 27 s in the priming group, 162 +/- 18 s in the ketamine group, and 168 +/- 22 s in the ketamine-priming group.
  
  
  CONCLUSIONS
  A low-dose ketamine used with a propofol-rocuronium induction improved intubating conditions and shortened onset time. Priming did not influence intubating conditions or onset time.
authors.affiliation: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara, 06100, Turkey.
authors.forename: Pelin Traje
authors.initials: PT
authors.lastname: Topcuoglu
authors.forename: Sennur
authors.initials: S
authors.lastname: Uzun
authors.forename: Ozgur
authors.initials: O
authors.lastname: Canbay
authors.forename: Gulsun
authors.initials: G
authors.lastname: Pamuk
authors.forename: Saadet
authors.initials: S
authors.lastname: Ozgen
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000732:Androstanols / Q000627:therapeutic use*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007649:Ketamine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000627:therapeutic use; D015742:Propofol / Q000627:therapeutic use*; D011446:Prospective Studies; D012044:Regression Analysis; D000077123:Rocuronium; D013997:Time Factors; D055815:Young Adult
chemical_list: D000700:Analgesics; D000732:Androstanols; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D007649:Ketamine; D000077123:Rocuronium; D015742:Propofol