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Facilitation of Rapid Endotracheal Intubations with Divided Doses of Nondepolarizing Neuromuscular Blocking Drugs

 

作者: Mahesh Mehta,   Won Choi,   Samir Gergis,   Martin Sokoll,   Andrew Adoiphson,  

 

期刊: Anesthesiology  (OVID Available online 1985)
卷期: Volume 62, issue 4  

页码: 392-395

 

ISSN:0003-3022

 

年代: 1985

 

出版商: OVID

 

关键词: Intubation: endotracheal;Neuromuscular relaxants: atracurium;d-tubocurarine;metocurine;pancuronium

 

数据来源: OVID

 

摘要:

The authors sought to determine whether prior administration of a small, subparalyzing dose of nondepolarizing muscle relaxant would shorten the onset time of an intubating dose of muscle relaxant. Initially, in 60 anesthetized patients, twitch response of adductor pollicis to ulnar nerve stimulation was studied after a small dose of pancuronium 0.015 mg·kg−1, metocurine 0.03 mg·kg−1, ord-tubocurarine 0.04 mg·kg−1, followed 3 min later by pancuronium 0.08 mg·kg−1or atracurium 0.4 mg·kg−1administered iv. After 60 s, the minimum neuromuscular block, in all patients was 79.0 ± 5.0%. A 95% depression or twitch tension occurred between 59.1 ± 5.3 and 86.1 ± 5.9 s. In another 60 patients, intubating conditions under similar regimen were studied, except the small dose of muscle relaxant was given immediately prior to induction of anesthesia. At the end of 60 s, good to excellent intubating conditions were present in 100% of the patients following the second dose of pancuronium and in 83% of the patients following atracurium. In 17% of the patients, after atracurium intubating conditions were fair. When nondepolarizing neuromuscular blocking drugs are administered in divided doses, neuromuscular blockade adequate for endotracheal intubation is achieved in less than 90 s. This facilitates rapid endotracheal intubation in a time comparable to using succinylcholine, without undesirable effects of the depolarizing neuromuscular blocking drugs.

 

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