The influence of fentanyl vs. s-ketamine on intubating conditions during induction of anaesthesia with etomidate and rocuronium

Ledowski, Thomas; Wulf, Hinnerk

doi:10.1046/j.1365-2346.2001.00886.x

Cited by 11 publications

(12 citation statements)

References 25 publications

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“…It was concluded that etomidate and rocuronium 0.6 mg/kg alone could not be recommended for RSI [I]. 135 The combination of etomidate 0.3 mg/kg and S-ketamine 0.5 mg/kg produced mostly excellent RSI intubation conditions using 0.6 mg/kg rocuronium 136 [I]. This effect could not be demonstrated using etomidate 0.3 mg/kg in combination with fentanyl 1.5 mg/kg.…”

Section: Choice Of a Hypnotic And An Opioid For Rsi With A Non-depolamentioning

confidence: 99%

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Jensen

Callesen

Hagemo

et al. 2010

Acta Anaesthesiol Scand

115

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Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high‐grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients should be given by, or under very close supervision by, experienced anaesthesiologists. Problems with the airway and the circulation must be anticipated. The risk of aspiration must be judged for each patient. Pre‐operative gastric emptying is rarely indicated. For pre‐oxygenation, either tidal volume breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre‐oxygenation in the obese patients should be performed in the head‐up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor influence on intubation conditions, and should be chosen on other grounds. Ketamine should be considered in haemodynamically compromised patients. Opioids may be used to reduce the stress response following intubation. For optimal intubation conditions, succinylcholine 1–1.5 mg/kg is preferred. Outside the operation room, rapid sequence intubation is also considered the safest method. For all patients, precautions to avoid aspiration and other complications must also be considered at the end of anaesthesia.

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Section: Choice Of a Hypnotic And An Opioid For Rsi With A Non-depolamentioning

confidence: 99%

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Jensen

Callesen

Hagemo

et al. 2010

Acta Anaesthesiol Scand

115

View full text Add to dashboard Cite

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“…20,21 However, the ketamine doses used in these studies were 1.5 mg kg -1 and 2.5 mg kg -1 , respectively. Ledowski and Wulf 22 found that the intubation conditions of 0.6 mg.kg -1 rocuronium were better in ketamine-etomidate induction group; however, arterial blood pressure and heart rate were also higher in this group. Leykin Abduşoğlu ve ark.…”

Section: Discussionmentioning

confidence: 82%

The Effects of a Subhypnotic Dose of Ketamine on Neuromuscular Block Characteristics of Rocuronium and Intubation Quality

Abduşoğlu¹,

Turan²,

Yurtlu³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T OOb bj je ec ct ti iv ve e: : In this study, we aimed to examine the effects of a subhypnotic dose of ketamine on the neuromuscular block characteristics of rocuronium and intubation quality. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Sixty patients in ASA I-II risk group were included in the study. Group S received 5 mL of 0.9% saline and Group K received 0.5 mg.kg -1 ketamine in 5 mL volume, one minute before induction. Both groups had anesthesia induction with a propofol dose of 2.5 mg.kg -1 (Propofol 1%, Fresenius Kabi). This was considered as anesthesia start time. After 1 min, a control single twitch stimulus (0.1 Hz) was applied and recorded. All patients were given 0.6 mg.kg -1 rocuronium (Esmeron ® 50 mg.5 ml -1 N.V. Organon, Oss, Holland) in 5 sec. When the single twitch response was depressed 100%, the patient was intubated and the full depression time (onset time) was noted. Anesthesia maintenance was achieved with O 2 /N 2 O and sevoflurane. Following the intubation, the application of train-of -four (TOF) stimulation was started. When the TOF ratio reached to 20%, rocuronium was repeated at a dose of 0.2 mg.kg . Clinical duration (T25), recovery index (T25-75) and spontaneous recovery time to TOF > 0.9 were recorded. Intubation conditions were assessed by using the scale of Fuchs-Buder. The additional drugs used during the operation and neuromuscular blocker amounts were recorded. The hemodynamic values of both groups were recorded throughout the study. Postoperative recovery times, visual analogue pain scores (VAS) and Ramsay sedation scores were also recorded. R Re es su ul lt ts s: : The time for 100% depression of single twitch in Group K was shorter than that of Group S (p<0.05). The clinical duration, recovery index and spontaneous recovery duration of the first dose of rocuronium were longer in Group K compared to Group S (p<0.05). There was no difference between the total neuromuscular blocker amounts of the study groups. There was no significant difference between the groups according to intubation scores (p>0.05), recovery times (p>0.05), VAS scores, Ramsay sedation scores or mean arterial pressure values. When the mean heart rate values of the groups were compared, all values of Group K were higher than those of Group S except control and 60 th min values (p<0.001). C Co on nc cl lu us si io on n: : According to our findings, ketamine in a subhypnotic dose shortens the onset time of rocuronium block and extends the clinical duration of first dose of rocuronium without improving the intubation quality.K Ke ey y W Wo or rd ds s: : Ketamine; propofol; rocuronium Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmada subhipnotik doz ketaminin rokuronyumun nöromusküler blok özellikleri ve entübasyon kalitesi üzerindeki etkilerini incelemeyi amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : ASA I-II risk grubundaki 60 hasta çalışmaya alındı. Grup S'ye 5 mL %0,9 serum fizyolojik verildi, Grup K'ya indüksiyondan bir dakika önce 5 mL 0,5 mg.kg -1 ketami...

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“…Grup 4'ün entübasyon skoru [13,5 (4-14)] Grup 1, 2 ve 5'e göre [12 (3-14), 11 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) ve 9,5 (0-13), sırası ile p=0,026, p=0,001, p=0,000001] daha iyi olarak değerlendirildi. Grup 3 [13 (4-14)] ve 4'ün [13,5 (4-14)] skorları benzerdi.…”

Section: Bulgularunclassified

“…Literatürde rokuronyumun etki oluşma süresini doz arttırma-dan kısaltmak için çeşitli ilaç kombinasyonları ve yöntemler tarif edilmektedir (4)(5)(6)(7)(8). Bu çalışmalarda, eklenen ilaçların, alışıldık indüksiyon dozlarından bağımsız olarak, nöromüs-küler blokerlerin etkilerinin oluşma sürelerine olan etkileri araştırılmıştır.…”

Section: Introductionunclassified

Influence of Different Doses of Ketamine on Intubating Conditions during a Rapid Sequence Induction and Intubation Model

Meço¹,

Bermede²,

Alanoğlu³

et al. 2016

Turk J Anaesth Reanim

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The influence of fentanyl vs. s-ketamine on intubating conditions during induction of anaesthesia with etomidate and rocuronium

Cited by 11 publications

References 25 publications

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

The Effects of a Subhypnotic Dose of Ketamine on Neuromuscular Block Characteristics of Rocuronium and Intubation Quality

Influence of Different Doses of Ketamine on Intubating Conditions during a Rapid Sequence Induction and Intubation Model

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