Evaluation of intubating conditions with rocuronium and either propofol or etomidate for rapid sequence induction

Anaesthesia. 1998 Jul;53(7):702-6. doi: 10.1046/j.1365-2044.1998.396-az0506.x.

Abstract

We have assessed the effect of two induction agents on tracheal intubating conditions after rocuronium 0.6 mg.kg-1 in unpremedicated patients undergoing simulated rapid sequence induction. Following pre-oxygenation, anaesthesia was induced with propofol up to 2.5 mg.kg-1 (n = 35) or etomidate 0.3 mg.kg-1 (n = 36), and further increments as required. After loss of verbal contact, cricoid pressure was applied and rocuronium was injected. Laryngoscopy was performed at 45 s and intubation attempted at 60 s after rocuronium had been given. Ninety-four per cent of patients in the propofol group had clinically acceptable (good or excellent) intubating conditions compared to only 75% in the etomidate group (p = 0.025). Owing to coughing, one patient in the etomidate group could not be intubated on the first attempt. A greater pressor response also followed intubation after induction with etomidate. We conclude that etomidate and rocuronium alone cannot be recommended for intubation at 60 s under rapid sequence induction conditions.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Androstanols*
  • Anesthetics, Intravenous* / pharmacology
  • Blood Pressure / drug effects
  • Double-Blind Method
  • Etomidate / pharmacology
  • Female
  • Heart Rate / drug effects
  • Humans
  • Intubation, Intratracheal*
  • Male
  • Middle Aged
  • Neuromuscular Nondepolarizing Agents*
  • Propofol / pharmacology
  • Rocuronium

Substances

  • Androstanols
  • Anesthetics, Intravenous
  • Neuromuscular Nondepolarizing Agents
  • Rocuronium
  • Propofol
  • Etomidate