Year :
2015
| Month :
September
| Volume :
9
| Issue :
9
| Page :
UC24 - UC28
Full Version
Intubating Conditions of two Different Doses of Rocuronium At 60 Seconds; by Clinical Assessment; and with T.O.F Response of Adductor Pollicis Muscle
Published: September 1, 2015 | DOI: https://doi.org/10.7860/JCDR/2015/.6499
Vijayakumar.M.Heggeri, Aparna S. Harbishettar, Ajitkumar Deka , Tejwant Rajkhowa
1. Assistant Professor, Department of Cardiac Anaesthesia, Shri Jayadeva Institute of Cardio Vascular Sciences and Research,
Banneraghatta Road-Bangalore, Karnataka, India.
2. Faculty, Department of General Medicine, IMO-Grade IIESIC Hospital-Peenya, Bangalore, India.
3. Professor & Former HOD, Department of Anaesthesiology and Critical Care Gauhati Medical College;
Chief Consultant, Department of Anaesthesiology and Intensive Care, Nam Care Hospital, Bhanghaghar, Gauhati, Assam, India.
4. Associate Professor, Department of Anaesthesiology and Critical Care, Gauhati Medical College-Guwahati-Assam, India.
Correspondence Address :
Dr. Vijayakumar. M.Heggeri,
Assistant Professor, Department of Cardiac Anaesthesia, Shri Jayadeva Institute of Cardio Vascular Sciences and Research,
Banneraghatta Road-Bangalore, Karnataka-560061, India.
E-mail : drvijay_heggeri@yahoo.com
Abstract
Background: At 60 seconds, 2xED95 dose (0.6mg/kg) of rocuronium is frequently used for intubation. Some studies suggest 3XED95 (0.9mg/kg body weight) dose in achieving excellent intubating conditions. In this context, present study aimed at comparing intubating conditions with these two doses of rocuronium, using clinical criteria by cooper’s score; assisted with adductor pollicis T.O.F response.
Materials and Methods: Present prospective randomized comparative clinical study was conducted on 60 patients subjected for general anaesthesia. Induction was done with fentanyl (1mcg/kg body weight) and propofol (2mg/kg body weight) and relaxation achieved with Rocuronium 0.6 mg/kg (Group A-30 cases); 0.9mg/kg (Group B- 30 cases). (n=30) intubation was done at 60 seconds.
Intubating conditions were assessed clinically by cooper’s score.T.O.F responses of AP by visual and tactile means.
Results: Intubating conditions clinically were excellent in 16 cases (53%), good in 12 cases (40%), and fair in 2 cases (7%) respectively in Group-A. In group-B excellent in 29 cases (97%) and good in 1case (3%).
In group A in no case TOF-0 achieved. TOF 1, 2, 3, and 4 were observed in 1 case (3%), 7 cases (23%) 16 cases (54%) and 6 cases (20%) respectively. Whereas in group B, TOF 0, 1, 2, 3 were observed in 18 cases (61%), 4 cases (13%), 7 cases (23%) and 1 case (3%). In no case TOF-4 observed. Chi square test (p<0.0001) confirmed a highly significant statistical difference with respect to elicited TOFcounts, and intubating conditions achieved.
Conclusion: 3xED95 dose of Rocuronium achieves more intense NMB and better conditions for intubation at 60 seconds than 2ED 95 dose.
Keywords
ED95, Fade, Non depolarizing muscle relaxant, Neuromuscular blockade, Supra maximal stimulus,Train of four response, Visual/tactile means
DOI: 10.7860/JCDR/2015/15528.6499
Date of Submission: Jul 03, 2015
Date of Peer Review: Jul 24, 2015
Date of Acceptance: Aug 04, 2015
Date of Publishing: Sep 01, 2015
Financial OR OTHER COMPETING INTERESTS: None.
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