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Excellent intubating conditions with remifentanil-propofol and either low-dose rocuronium or succinylcholine.
Can J Anaesth. 2009 Jul; 56(7):483-8.CJ

Abstract

PURPOSE

The shortest time to tracheal intubation, the best intubating conditions, and the shortest duration of muscle paralysis are achieved with succinylcholine. During a lidocaine-remifentanil-propofol induction of anesthesia, we compared intubating conditions 90 s after administering low-dose rocuronium (0.3 mg . kg(-1)) with intubating conditions 60 s after administering succinylcholine 1.5 mg . kg(-1).

METHODS

The randomized double-blind study included 184 healthy adult patients scheduled for elective surgery. Anesthesia was induced in all patients with lidocaine 1.5 mg . kg(-1), remifentanil 2 microg . kg(-1), and propofol 2 mg . kg(-1) administered over 30 s. In one group, rocuronium 0.3 mg . kg(-1) was administered before the induction sequence, and in the other group, succinylcholine 1.5 mg . kg(-1) was administered after the induction sequence. Laryngoscopy was attempted 90 s after rocuronium administration and 60 s after succinylcholine administration. Intubating conditions were assessed as excellent, good, or poor on the basis of ease of laryngoscopy, position of the vocal cords, and reaction to insertion of the tracheal tube and cuff inflation.

RESULTS

There were 92 patients per group. In the rocuronium group, intubating conditions were excellent in 83 patients (90%), good in 8 (9%), and poor in 1 (1%), not significantly different from the intubating conditions in the succinylcholine group, which were excellent in 88 patients (96%), good in 3 (3%), and poor in 1 (1%) (P = 0.3).

CONCLUSION

During a lidocaine-remifentanil-propofol induction of anesthesia, rocuronium 0.3 mg . kg(-1) administered before the induction sequence provides intubating conditions comparable to those achieved with succinylcholine 1.5 mg . kg(-1) administered after the induction sequence.

Authors+Show Affiliations

Department of Anesthesiology, American University of Beirut Medical Center, P.O. Box 11-0236, Beirut, Lebanon.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19440810

Citation

Siddik-Sayyid, Sahar M., et al. "Excellent Intubating Conditions With Remifentanil-propofol and Either Low-dose Rocuronium or Succinylcholine." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 56, no. 7, 2009, pp. 483-8.
Siddik-Sayyid SM, Taha SK, Kanazi GE, et al. Excellent intubating conditions with remifentanil-propofol and either low-dose rocuronium or succinylcholine. Can J Anaesth. 2009;56(7):483-8.
Siddik-Sayyid, S. M., Taha, S. K., Kanazi, G. E., Chehade, J. M., Zbeidy, R. A., Al Alami, A. A., Zahreddine, B. W., Khatib, M. F., Baraka, A. S., & Aouad, M. T. (2009). Excellent intubating conditions with remifentanil-propofol and either low-dose rocuronium or succinylcholine. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 56(7), 483-8. https://doi.org/10.1007/s12630-009-9106-x
Siddik-Sayyid SM, et al. Excellent Intubating Conditions With Remifentanil-propofol and Either Low-dose Rocuronium or Succinylcholine. Can J Anaesth. 2009;56(7):483-8. PubMed PMID: 19440810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Excellent intubating conditions with remifentanil-propofol and either low-dose rocuronium or succinylcholine. AU - Siddik-Sayyid,Sahar M, AU - Taha,Samar K, AU - Kanazi,Ghassan E, AU - Chehade,Jules-Marie A, AU - Zbeidy,Reine A, AU - Al Alami,Achir A, AU - Zahreddine,Badri W, AU - Khatib,Mohamad F, AU - Baraka,Anis S, AU - Aouad,Marie T, Y1 - 2009/05/14/ PY - 2008/10/21/received PY - 2009/03/31/accepted PY - 2009/03/18/revised PY - 2009/5/15/entrez PY - 2009/5/15/pubmed PY - 2009/10/22/medline SP - 483 EP - 8 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 56 IS - 7 N2 - PURPOSE: The shortest time to tracheal intubation, the best intubating conditions, and the shortest duration of muscle paralysis are achieved with succinylcholine. During a lidocaine-remifentanil-propofol induction of anesthesia, we compared intubating conditions 90 s after administering low-dose rocuronium (0.3 mg . kg(-1)) with intubating conditions 60 s after administering succinylcholine 1.5 mg . kg(-1). METHODS: The randomized double-blind study included 184 healthy adult patients scheduled for elective surgery. Anesthesia was induced in all patients with lidocaine 1.5 mg . kg(-1), remifentanil 2 microg . kg(-1), and propofol 2 mg . kg(-1) administered over 30 s. In one group, rocuronium 0.3 mg . kg(-1) was administered before the induction sequence, and in the other group, succinylcholine 1.5 mg . kg(-1) was administered after the induction sequence. Laryngoscopy was attempted 90 s after rocuronium administration and 60 s after succinylcholine administration. Intubating conditions were assessed as excellent, good, or poor on the basis of ease of laryngoscopy, position of the vocal cords, and reaction to insertion of the tracheal tube and cuff inflation. RESULTS: There were 92 patients per group. In the rocuronium group, intubating conditions were excellent in 83 patients (90%), good in 8 (9%), and poor in 1 (1%), not significantly different from the intubating conditions in the succinylcholine group, which were excellent in 88 patients (96%), good in 3 (3%), and poor in 1 (1%) (P = 0.3). CONCLUSION: During a lidocaine-remifentanil-propofol induction of anesthesia, rocuronium 0.3 mg . kg(-1) administered before the induction sequence provides intubating conditions comparable to those achieved with succinylcholine 1.5 mg . kg(-1) administered after the induction sequence. SN - 1496-8975 UR - https://www.unboundmedicine.com/medline/citation/19440810/Excellent_intubating_conditions_with_remifentanil_propofol_and_either_low_dose_rocuronium_or_succinylcholine_ L2 - https://doi.org/10.1007/s12630-009-9106-x DB - PRIME DP - Unbound Medicine ER -