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Evaluating Rapid Tracheal Intubations by Priming Method and Usual Dose of Atracurium
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Roodneshin F *   , Agah M |
| , dr_roodneshin_f2007@yahoo.com |
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Abstract: (10523 Views) |
| Background and Aim: According to increased trend for rapid intubations of trachea on one hand and need for importance of muscle relaxation during intubations process on the other hand, we conduct this research to evaluate using priming method by usual dose of Atracurium with Succinylcholine.
Materials and methods: One hundred participants by age ranged between 15 to 55 years old underwent in doubled blind clinical trial research. They had no anatomical troubles in their tracheal air way. They were assigned randomly in two groups named group (S) which stands for Succinylcholine, and group (P) which stands for priming. As premedication, both groups received 0.5-1.5 mg dose of Midazolam and 2 µg/kg dose of Fentanyl intravenously, and also group (P) received 0.05 mg/kg dose of Atracurium while group (S) nothing but 0.5 cc of normal saline. Both groups were oxygenized for three minutes followed by anesthetic induction by using some drugs such as 5-6 mg/kg dose of thiopental and 1.5 mg/kg of lidocaine. During induction, group (S) received 1.5 mg/kg Succinylcholine while group (P) received 0.55 mg/kg of atracurium. All participants in research in both groups were intubated by an expert anesthesiologist after 60 seconds.
Muscle relaxation was recorded based on applying single twitch neurostimulator (ST) that to determine it we assign three numbers which includes 0, 1, and 2. Zero was for nonexistence of it, 1 for moderate and 2 for complete relaxation, and also it was based on other clinical criteria such as mandibular relaxation (0, 1), openness of vocal cord (0, 1) and not bucking (0, 1 and 2). Subjects were considered completely relaxed when the sum of scores was 4, and relatively relaxed when it was 3. The effects of these approaches were judged based on muscle relaxation associated with evaluation of clinical examination and ST by using key do and fisher test.
Results: Data showed that none of the subjects got 2 or less than it from the sum of scores of the degree of muscle relaxation and clinical evaluation, and also it showed that 16% of control group and 8% of experimental group got relatively relaxed (not significant). Based on ST, there were No. 1 or zero grades in all patients in control group vs. relatively relaxation in 64% of patients in experimental one (p<0.000001).
Conclusion: New priming method is as same as method which we use Succinylcholine at least in clinical respect. We recommend using the mentioned method in patients who are candidates for contraindication of using Succinylcholine. We suggest a more complete research with evaluating Train of Four (TOF). |
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| Keywords: Intubation, Rapid; Anesthesia; Succinylcholine; Atracurium; Priming with Usual Dose |
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Full-Text [PDF 87 kb]
(5281 Downloads)
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Type of Study: Original |
Subject:
Medicine
Received: 2017 | Published: 2017
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