Evaluation of intubating conditions after rocuronium bromide in adults induced with propofol or thiopentone sodium

Abstract

Aim:The aims of present study were to compare the propofol and rocuronium with thiopentone and rocuronium in terms of clinically satisfactory intubating conditions and to co-relate intubating conditions with degree of paralysis in adductor pollicis muscle using train of four ratio (TOFR). The intubating conditions were evaluated after rocuronium bromide 0.6 mg kg-1 at 60 s.Materials and Methods:60 patients of ASA grades I-II of either sex, age 18-50 years, undergoing various elective surgical procedures were randomly divided into two groups, propofol rocuronium (PR group) and thiopentone rocuronium (TR group) of 30 patients in each. In the PR group, patients received propofol 2.5 mg kg-1 and rocuronium 0.6 mg kg-1; in TR group, patients received thiopentone 5 mg kg-1 and rocuronium 0.6 mg kg-1. In all patients the intubating conditions were evaluated by the observer at 60 s. TOFR was measured at the time of intubation by an assistant.Results:In the PR group the number of the patients placed in intubating conditions grades I, II, III and IV were 40%, 36.67%, 13.33% and 10% and their mean TOFR were 31.8±17.9%, 61.8±;14.6%, 61.7±27.9%, and 78.3±5.7% respectively. While in theTR group the number of patients placed in intubating condition grade I, II, and III were 60%, 26.67%, and 13.33% and their mean TOFR , 41.2±28.3%, 68.0±10.9% and 78.7±6.8%, respectively. There was no patient in grade lV in theTR group.Conclusion:The clinical intubating conditions and degree of paralysis of adductor pollicis muscle after rocuronium 0.6 mg kg-1 at 60 s in adults induced with propofol or thiopentone sodium are comparable.

Transnasal Humidified Rapid Insufflation Ventilatory Exchange With Nasopharyngeal Airway Facilitates Apneic Oxygenation: A Randomized Clinical Noninferiority Trial

“…A neuromuscular block monitor would help indicate the start point of apnea after induction. According to Jeung and Shahnawaz, 0.6 mg/kg of rocuronium plus the indicated doses of other induction anesthetics would terminate spontaneous breathing in a normal adult within 1 min ( 22 , 23 ). Therefore, the performer, who is the same person who analyzed all the recruited patients, would keep a close eye on the patients' chest movement since the start of anesthetic induction to guarantee that the onset of apnea would be immediately detected.…”

Evaluation of intubating conditions with rocuronium 0.6 mg/kg using train of four stimulation in elective surgery

“…We found no difference with the use of propofol and thiopentone or other agents, however, some researchers have reported clinically excellent conditions in 60% of patients with thiopentone at 60 seconds as compared to 40% with propofol. [ 19 ] Skinner et al . [ 13 ] reported better intubating conditions with propofol (acceptable in 94% of patients) as compared to 75% with etomidate.…”