Effectiveness of the timing principle with high-dose rocuronium during rapid sequence induction with lidocaine, remifentanil and propofol

Suzuki, Takahiro; Aono, M; Fukano, Naoko; Kobayashi, Makiko; Saeki, Shigeru; Ogawa, Setsuro

doi:10.1007/s00540-010-0880-y

Cited by 10 publications

(11 citation statements)

References 22 publications

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“…Hence, it is not suitable in situations like neuromuscular disorders, burns, acute head injury, intracranial bleed,[4] open eye injury, spinal cord injury,[5] cerebrovascular accidents and renal diseases. The above side-effects and contraindications of succinylcholine had prompted the use of non-depolarizing muscle relaxants using various techniques for rapid sequence intubation, such as (1) timing principles,[6] (2) combination of relaxant,[7] (3) high dose of non-depolarizing muscle relaxants,[8] (4) inhalational agents to augment the effect of non-depolarizing muscle relaxants,[9] (5) use of intravenous anaesthetic agents with non-depolarizing muscle relaxants to augment neuromuscular blockade[10] and (6) priming principle.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intubating conditions between rocuronium with priming and without priming: Randomized and double-blind study

2011

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Background:Rocuronium produces faster neuromuscular blockade compared with other neuromuscular blocking drugs. It produces comparable intubating conditions to that of succinylcholine, but does not have the short intubation time of the latter. Hence, it may not be preferable for rapid sequence intubation, but rocuronium with priming may produce comparable intubating time and conditions to that of succinylcholine. Rocuronium with priming may be an alternative to succinylcholine in rapid sequence intubation in conditions where succinylcholine is contraindicated. The present study was conducted to compare the intubating conditions and intubation time of rocuronium with and without priming.Methods:Sixty patients of ASA physical status I and II, aged between 18 and 60 years, of both sexes, were divided into priming and control groups of 30 each. Patients in the priming group received 0.06 mg/kg of rocuronium and those in the control group received normal saline. All patients received fentanyl 1 μg/kg, followed by thiopentone 5 mg/kg for induction. Intubating dose of rocuronium 0.54 mg/kg in the priming group and 0.6 mg/kg in the control group were administered 3 min after priming. Onset time of intubation was assessed using a Train of Four stimuli, and the intubating conditions were compared by the Cooper scoring system.Results:The onset time of intubation was 50.67±7.39 s in the priming group and 94.00±11.62 s in the control group, with excellent intubating conditions in both the groups and without any adverse effects.Conclusions:Priming with rocuronium provides excellent intubating conditions in less than 60 s with no adverse effects.

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Section: Introductionmentioning

confidence: 99%

Comparison of intubating conditions between rocuronium with priming and without priming: Randomized and double-blind study

2011

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“…Therefore, establishing a fast and profound neuromuscular block is required for rapid sequence intubation. Although priming [17] and timing principles [18] using rapid-onset rocuronium have been reported to be effective for rapid sequence intubation, suxamethonium seems to be clinically preferred rather than rocuronium as a neuromuscular blocking agent for patients with specific risks of pulmonary aspiration. In fact, a survey of variation of rapid sequence induction techniques in Wales reported that suxamethonium was currently used for 97% of cesarean sections, 94% of bowel obstructions, and 85% of appendectomies; in contrast, rocuronium was used only in 2-12% of patients [2].…”

Section: Discussionmentioning

confidence: 95%

A randomized trial to identify optimal precurarizing dose of rocuronium to avoid precurarization-induced neuromuscular block

et al. 2011

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“…Rocuronium has been shown to be as effective as succinylcholine in facilitating laryngoscopy during RSII [5,6]. Administration of rocuronium (1 mg/kg) immediately prior to administration propofol facilitates good to excellent intubating conditions within 60 s of dosing in non trauma patients, which is comparable to succinylcholine [4,7]. There is limited data regarding the use of vecuronium for RSII, and this agent is not generally recommended due to a longer onset time (80-140 s), even when larger doses are used (0.3 mg/kg) [8][9][10].…”

Section: Induction Agentsmentioning

confidence: 99%

Choice of General Anesthetics for Trauma Patients

Sikorski

Koerner

Fouché-Weber

et al. 2014

Curr Anesthesiol Rep

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The trauma anesthesiologist has multiple competing concerns when supporting the patient with major trauma, but the priority must be focused on adequate resuscitation to facilitate surgical hemostasis. A broad, evidence-informed knowledge of airway management, resuscitation, physiology, pharmacology, and critical care is required to address the unique pathophysiological processes encountered in trauma. Judicious selection of anesthetic agents is crucial to ensure optimal outcomes. In this review, we describe approaches for the induction and maintenance of general anesthesia for the patient with major trauma. Considerations for ongoing resuscitation and hemodynamic instability will be explored and discussed with respect to the administration of anesthetic induction and maintenance agents. Practices at our institution are reviewed, including the administration of high-dose opioids as an integral part of both resuscitation and anesthesia for the patient with major trauma.

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Effectiveness of the timing principle with high-dose rocuronium during rapid sequence induction with lidocaine, remifentanil and propofol

Abstract: Application of the timing principle with 1 mg kg(-1) rocuronium is beneficial for rapid tracheal intubation. Co-administered lidocaine, remifentanil and propofol can definitely suppress cardiovascular responses during laryngoscopy and intubation.

Cited by 10 publications

References 22 publications

Comparison of intubating conditions between rocuronium with priming and without priming: Randomized and double-blind study

Comparison of intubating conditions between rocuronium with priming and without priming: Randomized and double-blind study

A randomized trial to identify optimal precurarizing dose of rocuronium to avoid precurarization-induced neuromuscular block

Choice of General Anesthetics for Trauma Patients

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