Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Eur J Anaesthesiol. 2013 Sep;30(9):550-5. doi: 10.1097/EJA.0b013e3283622ba0.
Full relaxation is not mandatory for successful tracheal intubation.
We tried to find the dose of rocuronium that gave acceptable intubation conditions in a rapid sequence intubation with remifentanil and propofol.
A dose-finding study of rocuronium using a modified Dixon's up-and-down method.
A single tertiary care teaching hospital.
Patients undergoing elective surgery under general anaesthesia.
After premedication with midazolam and glycopyrrolate, anaesthesia was induced using remifentanil 2 μg kg and propofol 2 mg kg, and a predetermined dose of rocuronium was administered. The dose of rocuronium was determined by a modified Dixon's up-and-down method starting from 0.8 mg kg with an interval of 0.1 or 0.05 mg kg. Intubation was performed 60 s after the start of the rocuronium injection. Intubation conditions were graded as excellent, good or poor. Excellent or good were regarded as clinically acceptable.
A dose of rocuronium needed for acceptable intubation condition in 50% of patients (ED50) during rapid tracheal intubation after induction of anaesthesia with remifentanil and propofol.
Twenty-eight patients were enrolled to obtain six crossovers. The ED50 of rocuronium was 0.20 mg kg (95% confidence interval, CI 0.17 to 0.23 mg kg) by a modified Dixon's up-and-down method.
After induction of anaesthesia with remifentanil 2 μg kg and propofol 2 mg kg, the ED50 of rocuronium for acceptable intubation condition was 0.20 mg kg (95% CI, 0.17 to 0.23 mg kg) for rapid sequence intubation. Thus, we recommend that the intubation dose should be 0.8 mg kg.
Clinical trial registration KCT0000094.
完全松弛并非成功气管插管的必要条件。
我们试图在瑞芬太尼和丙泊酚诱导的快速序贯气管插管中找到可接受插管条件的罗库溴铵剂量。
使用改良 Dixon 上下法的罗库溴铵剂量发现研究。
一家三级保健教学医院。
在全身麻醉下接受择期手术的患者。
在咪达唑仑和格隆溴铵预处理后，使用瑞芬太尼 2μg/kg 和丙泊酚 2mg/kg 诱导麻醉，并给予预定剂量的罗库溴铵。罗库溴铵的剂量通过改良 Dixon 上下法确定，起始剂量为 0.8mg/kg，间隔 0.1 或 0.05mg/kg。罗库溴铵注射开始后 60s 进行插管。插管条件分为优秀、良好或差。优秀或良好被认为是临床可接受的。
瑞芬太尼和丙泊酚诱导麻醉后快速气管插管时 50%患者可接受插管条件的罗库溴铵剂量（ED50）。
纳入 28 例患者进行 6 次交叉。改良 Dixon 上下法得出罗库溴铵的 ED50 为 0.20mg/kg（95%置信区间，0.17 至 0.23mg/kg）。
瑞芬太尼 2μg/kg 和丙泊酚 2mg/kg 诱导麻醉后，罗库溴铵用于快速序贯插管可接受插管条件的 ED50 为 0.20mg/kg（95%置信区间，0.17 至 0.23mg/kg）。因此，我们建议插管剂量应为 0.8mg/kg。
临床试验注册号 KCT0000094。
