Vijayakumar M Heggeri1, Aparna S Harbishettar2, Ajitkumar Deka3, Tejwant Rajkhowa4. 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 .
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.
RCT Entities:
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.
Entities:
Keywords:
ED95; Fade; Neuromuscular blockade; Non depolarizing muscle relaxant; Supra maximal stimulus; Train of four response; Visual/tactile means
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