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.
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 -
