[Neuromuscular block monitoring for optimisation of conditions for endotracheal intubation].
BACKGROUND
The choice of an appropriate moment for endotracheal intubation is essential to avoid serious motor and cardiovascular reactions during laryngoscopy and tube insertion.The purpose of the study was to compare the effects of intubation on laryngoscopy conditions and cardiovascular response, when choice of the moment for intubation was directed by either clinical or train-of-four assessment.


METHODS
Adult ASA I patients, scheduled for lumbar disc hernia surgery, who received 0.15 mg kg(-1) of cis-atracurium for muscle relaxation, were divided in two groups. Patients in group I were intubated when the attending anaesthesiologist assessed muscle relaxation to be adequate. Patients in group II were intubated when there was no visual response to train-of-four stimulation of the ulnar nerve.


RESULTS
Forty-five patients were enrolled in the study. The mean time for intubation was 162.3+/-35 sec in group I and 339.3+/-73.7 sec in group II. Adequate and excellent conditions for intubation were achieved in all patients of group II, compared to only 53% of patients in group I. Heart rate and arterial blood pressure immediately after intubation were significantly lower (p<0.001) in group II.


CONCLUSIONS
The objective assessment of neuromuscular relaxation priorto endotracheal intubation provides better conditions and minimization of cardiovascular reaction.
Witkowska
Małgorzata
M
Zakład Neuroanestezjologii, Gdański Uniwersytet Medyczny, Gdańsk.
Karwacki
Zbigniew
Z
Wierzchowska
Jolanta
J
Bukowski
Paweł
P
D000328:Adult; D001279:Atracurium / Q000008:administration & dosage*; D001794:Blood Pressure; D004558:Electric Stimulation; D005260:Female; D006339:Heart Rate; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D007442:Intubation, Intratracheal / Q000379:methods*; D007828:Laryngoscopy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D009407:Nerve Block / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D013997:Time Factors; D014459:Ulnar Nerve
D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium