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Dose of rocuronium for rapid tracheal intubation following remifentanil 2 μg kg-1 and propofol 2 mg kg-1.
Eur J Anaesthesiol. 2013 Sep; 30(9):550-5.EJ

Abstract

CONTEXT

Full relaxation is not mandatory for successful tracheal intubation.

OBJECTIVE

We tried to find the dose of rocuronium that gave acceptable intubation conditions in a rapid sequence intubation with remifentanil and propofol.

DESIGN

A dose-finding study of rocuronium using a modified Dixon's up-and-down method.

SETTING

A single tertiary care teaching hospital.

PARTICIPANTS

Patients undergoing elective surgery under general anaesthesia.

INTERVENTIONS

After premedication with midazolam and glycopyrrolate, anaesthesia was induced using remifentanil 2 μg kg and propofol 2 mg kg, and a predetermined dose of rocuronium was administered. The dose of rocuronium was determined by a modified Dixon's up-and-down method starting from 0.8 mg kg with an interval of 0.1 or 0.05 mg kg. Intubation was performed 60 s after the start of the rocuronium injection. Intubation conditions were graded as excellent, good or poor. Excellent or good were regarded as clinically acceptable.

MAIN OUTCOME MEASURE

A dose of rocuronium needed for acceptable intubation condition in 50% of patients (ED50) during rapid tracheal intubation after induction of anaesthesia with remifentanil and propofol.

RESULTS

Twenty-eight patients were enrolled to obtain six crossovers. The ED50 of rocuronium was 0.20 mg kg (95% confidence interval, CI 0.17 to 0.23 mg kg) by a modified Dixon's up-and-down method.

CONCLUSION

After induction of anaesthesia with remifentanil 2 μg kg and propofol 2 mg kg, the ED50 of rocuronium for acceptable intubation condition was 0.20 mg kg (95% CI, 0.17 to 0.23 mg kg) for rapid sequence intubation. Thus, we recommend that the intubation dose should be 0.8 mg kg.

TRIAL REGISTRATION

Clinical trial registration KCT0000094.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

23698704

Citation

Oh, Ah-Young, et al. "Dose of Rocuronium for Rapid Tracheal Intubation Following Remifentanil 2 Μg Kg-1 and Propofol 2 Mg Kg-1." European Journal of Anaesthesiology, vol. 30, no. 9, 2013, pp. 550-5.
Oh AY, Cho SJ, Seo KS, et al. Dose of rocuronium for rapid tracheal intubation following remifentanil 2 μg kg-1 and propofol 2 mg kg-1. Eur J Anaesthesiol. 2013;30(9):550-5.
Oh, A. Y., Cho, S. J., Seo, K. S., Ryu, J. H., Han, S. H., & Hwang, J. W. (2013). Dose of rocuronium for rapid tracheal intubation following remifentanil 2 μg kg-1 and propofol 2 mg kg-1. European Journal of Anaesthesiology, 30(9), 550-5. https://doi.org/10.1097/EJA.0b013e3283622ba0
Oh AY, et al. Dose of Rocuronium for Rapid Tracheal Intubation Following Remifentanil 2 Μg Kg-1 and Propofol 2 Mg Kg-1. Eur J Anaesthesiol. 2013;30(9):550-5. PubMed PMID: 23698704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dose of rocuronium for rapid tracheal intubation following remifentanil 2 μg kg-1 and propofol 2 mg kg-1. AU - Oh,Ah-Young, AU - Cho,Suk-Ju, AU - Seo,Kwang-Suk, AU - Ryu,Jung-Hee, AU - Han,Sung-Hee, AU - Hwang,Jung-Won, PY - 2013/5/24/entrez PY - 2013/5/24/pubmed PY - 2014/11/5/medline SP - 550 EP - 5 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 30 IS - 9 N2 - CONTEXT: Full relaxation is not mandatory for successful tracheal intubation. OBJECTIVE: We tried to find the dose of rocuronium that gave acceptable intubation conditions in a rapid sequence intubation with remifentanil and propofol. DESIGN: A dose-finding study of rocuronium using a modified Dixon's up-and-down method. SETTING: A single tertiary care teaching hospital. PARTICIPANTS: Patients undergoing elective surgery under general anaesthesia. INTERVENTIONS: After premedication with midazolam and glycopyrrolate, anaesthesia was induced using remifentanil 2 μg kg and propofol 2 mg kg, and a predetermined dose of rocuronium was administered. The dose of rocuronium was determined by a modified Dixon's up-and-down method starting from 0.8 mg kg with an interval of 0.1 or 0.05 mg kg. Intubation was performed 60 s after the start of the rocuronium injection. Intubation conditions were graded as excellent, good or poor. Excellent or good were regarded as clinically acceptable. MAIN OUTCOME MEASURE: A dose of rocuronium needed for acceptable intubation condition in 50% of patients (ED50) during rapid tracheal intubation after induction of anaesthesia with remifentanil and propofol. RESULTS: Twenty-eight patients were enrolled to obtain six crossovers. The ED50 of rocuronium was 0.20 mg kg (95% confidence interval, CI 0.17 to 0.23 mg kg) by a modified Dixon's up-and-down method. CONCLUSION: After induction of anaesthesia with remifentanil 2 μg kg and propofol 2 mg kg, the ED50 of rocuronium for acceptable intubation condition was 0.20 mg kg (95% CI, 0.17 to 0.23 mg kg) for rapid sequence intubation. Thus, we recommend that the intubation dose should be 0.8 mg kg. TRIAL REGISTRATION: Clinical trial registration KCT0000094. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/23698704/Dose_of_rocuronium_for_rapid_tracheal_intubation_following_remifentanil_2_��g_kg_1_and_propofol_2_mg_kg_1_ L2 - https://doi.org/10.1097/EJA.0b013e3283622ba0 DB - PRIME DP - Unbound Medicine ER -