Succinylcholine has quicker onset of action, reliable and excellent intubating conditions with shorter duration but has undesirable side effects as fasciculation, rise intraocular pressure, rise in intragastric pressure and subsequent vomiting and regurgitation hyperkalaemia, rise serum CPK levels, myalgia and myoglobinuria. It is contraindicated in anticipated difficult intubation, severe kidney and liver disease, trauma, pregnancy, etc. Many methods were tried to decrease these side effects of succinylcholine by many scientists. Pretreatment with non-depolarizing muscle relaxant is one of that which found to be successful. In the present study, Rocuronium and Vecuronium were tried to evaluate their efficacy in reducing post succinylcholine fasciculation, intubating conditions, serum potassium and CPK, myalgia and myoglobin; 150 patients were divided into three groups according to administration normal saline Rocuronium, Vecuronium as pretreatment before Succinylcholine where general anaesthesia administration was essential. It was observed that pretreatment with Rocuronium and Vecuronium significantly reduced incidence and severity of fasciculation, better intubating conditions, no change in serum potassium and CPK levels, reduction in Myalgia and no change in myoglobin postoperatively. Rocuronium was found to be better than Vecuronium in all respects to minimize side effects of Succinylcholine.
In paediatric patients, smooth induction with rapid endotracheal intubation without morbidity and mortality is of prime importance. Many of the inhalational anaesthetic agents have been tried for this purpose. In the present study, Sevoflurane due to its high potency, rapid induction, excellent intubating conditions with haemodynamic stability was compared with Halothane in paediatric patients. In the present study, 60 paediatric patients of ASA grade I and II of either sex were divided into 2 equal groups of 30 each according to inhalational anaesthetic agent used for induction of anaesthesia. In group S, Sevoflurane 8% and group H Halothane 3% were used for induction of anaesthesia with Nitrous oxide/oxygen mixture on Boyles' anaesthesia machine. All patients received Inj. Glycopyrrolate 5-8 µgm/kg and inj. Midazolam 0.25 µgm/kg as premedication 10 minutes prior to the induction of anaesthesia. It was observed that mean induction time in group S was 210±17 secs. and in Group H was 262±21 secs. Sevoflurane has low blood/gas co-efficient of 0.69 as compared to Halothane 2.5, so quicker induction time with Sevoflurane as compared to Halothane. In group S, 90% of patients had excellent intubating conditions, 7% good, and 3% had fair while in group H 84% had excellent intubating conditions, 13% had good, and 3% had fair intubating conditions. During intubation, mean pulse rate decreased significantly in both groups and increased after intubation. The decrease in pulse rate was comparatively less in group S than group H and also there was significant increase in pulse rate after intubation in both groups. Similar changes were observed with mean systolic blood pressure and mean arterial pressure in both groups. Thus, Sevoflurane provided better cardiovascular stability during and after intubation as compared to Halothane. We observe that, Sevoflurane due to its cardiovascular stability, smooth induction, and excellent intubating conditions maybe preferred over Halothane in paediatric patients for endotracheal intubation.
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