Clinical Observation Of Different Techniques Of Rocuronium For Rapid Sequence Induction And Intubation

ObjectiveTo observate if rocuronium (2×ED95) can be applicated in rapid sequence induction and intubation by using timing principle and priming principle; to observate if the intubation conditions were improved by using timing principle and priming principle during rapid sequence induction and intubation; the effects of primed with rocuronium and mivacurium took on onset time and time to loss of TOF reaction of rocuronium.Methods80patients were randomizedly divided into four groups of20each: group of timing principle (Group R)、group primed with rocuronium (Group RR). group primed with mivacurium (Group MR) and control group (Group CR). Patients allocated to the timing group (Group R) received rocuronium0.6mg/kg firstly, then anesthesia was induced with fentanyl (5ug/kg) and propofol (1.5mg/kg) at the onset of clinical weakeness (ptosis); Patients in group RR and group MR received0.1×ED95priming dose of rocuronium (0.03mg/kg) or mivacurium (0.008mg/kg), and anesthesia was induced with fentanyl (5ug/kg) and propofol (1.5mg/kg) at the2.5minute, and then intubating dose of rocuronium (0.57mg/kg) at the4minute; patients in group CR received saline (10ml)4minutes before the administration of rocuronium (0.6mg/kg), the rest was the same with priming group. Laryngoscopy started at the50second after administration of the last intubation agent and intubation was accomplished at the60second in all groups. Intubation conditions were assessed according to a grading scale, the onset time, time to loss of TOF response and train of four at intubation were observed. Haemodynamic variables were recorded and comparied before and after intubation.ResultsIntubation conditions of the timing group (Group R) were better than that of control group (Group CR), P<0.05, there were no statistical significance among other groups, P>0.05; the excellent intubaton condition of the timing group (Group R) was more than that of control group (Group CR), P<0.05, there were no statistical significance among other groups, P>0.05; there were no statistical significance about the clinical acceptable intubation condition among the four groups, P>0.05; the onset time of the group primed with mivacurium (Group MR) was shorter than that of the timing group (Group R) and control group (Group CR), P＜0.05, there were no statistical significance among other groups, P>0.05; there were no statistical significance about the time to loss of TOF among the four groups, P>0.05. Haemodynamic variables were roughly stable during intubation period in all groups.Conclusion:1Timing principle of rocuronium can improve the intubation conditions during rapid sequence induction and intubation, there is little improvement of the intubation conditions using the priming principle of rocuronium;2The onset time of rocuronium is shorter by primed with mivacurium, and have little change by primed with rocuronium;3Rocuronium is more suitable for rapid sequence induction and intubation by using timing principle because this technique can shorten the time of induction and intubation.