Abstract
The purpose of the study was to determine intubating conditions after administration of either succinylcholine or vecuronium in a rapid induction sequence. Patients received either succinylcholine 1.5 mg· kg− 1 (Groups I and II) after d-tubocurarine 0.05 mg · kg− 1 four minutes earlier, or vecuronium (Groups III and IV) in an initial dose of 0.01 mg · kg− 1 followed four minutes later by 0.1 mg · kg− 1. In Groups I and III an apnoeic delay of one minute was allowed before intubation whereas in Groups II and IV the delay was 90 sec. There was no significant difference in intubating conditions between Groups I and IV. Intubating conditions in Group III (vecuronium — delay of one minute were statistically worse than in any of the three other groups. A delay of 90 sec after succinylcholine improved intubating conditions in male patients. Considering that intubating conditions obtained after 90 sec in patients given a priming sequence with vecuronium (Group IV) were not different from those obtained 60 sec after succinylcholine (Group I), the authors conclude that vecuronium is an acceptable alternative for rapid tracheal intubation. In the doses used in this study, intubating conditions 60 sec after vecuronium were unacceptable for rapid induction of anaesthesia.
Résumé
L’étude avait pour but de vérifier les conditions d’intubation lors d’une induction à séquence rapide utilisant la succinylcholine ou le vécuronium comme myorelaxant. Les patients des Groupes I et II recevaient un pré-traitement avec de la d-tubocurarine 0,05mg · kg− 1 suivi quatre minutes plus tard de succinylcholine 1.5 mg · kg− 1. Les patients des Groupes III et IV recevaient une dose d’amorce de vécuronium de 0,01 mg · kg− 1, suivie quatre minutes plus tard d’une dose de 0,1 mg · kg− 1. Le délai entre l’administration du myorelaxant et l’intubation était de une minute dans les Groupes I et III, alors que dans les Groupes II et IV ce délai était de 90 sec. Il n’y avait pas de différence statistiquement significative dans les conditions d’intubation entre les Groupes I et IV. Statistiquement, les moins bonnes conditions d’intubation se sont retrouvées chez les patients du Groupe III (vécuronium — délai d’une minute). Un délai de 90 sec après l’administration de la succinylcholine améliorait significativement les conditions d’intubation chez les patients de sexe masculin. Etant donné que les conditions d’intubation des patients du groupe IV (vécruonium-délai de 90 sec) n’étaient pas differentes de celles des patients du Groupe I (succinylcholine-délai d’une minute), les auteurs concluent que le vécuronium constitue une alternative valable à la succinylcholine comme myorelaxant pour l’intubation à séquence rapide. Les conditions d’intubation 60 sec après l’administration de vécuronium aux doses utilisées dans cette étude étaient inacceptables.
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This study was supported in part by a grant from the University of Montreal.
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Boulanger, A., Hardy, JF. & Lepage, Y. Rapid induction sequence with vecuronium: should we intubate after 60 or 90 seconds?. Can J Anaesth 37, 296–300 (1990). https://doi.org/10.1007/BF03005578
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DOI: https://doi.org/10.1007/BF03005578