Clinical Evaluation of Vecuronium in Divided Doses for Endotracheal Intubation / 대한마취과학회지

ABSTRACT

In the clinical situations which the use of SCC for endotracheal incubation is contraindi-cated, we have currently tried to find semi ideal substitutes for SCC. One of these, neuromuscular blockade will occur sooner if the intubating dose of a non-depolarizing drug is proceded by a small, subparalyzing initial dose. Our previous studs for the divided doses of pancuronium was concluded to be a substi- tute for SCC. However, the slow onset and long duration of pancuronium were net suita-ble in some clinical applications. This study was undertaken to eatimate a newer shorter acting relaxant, vecuronium, in divided doses to apply for rapid sequence endotracheal intubation. The subparalyzing dose, 0.01 mg/kg, of vencuronium 4 min. prior to its intubating dose, 0.1 mg/kg, for all patients was administered under the monitoring of TOF response with Relaxograph. The intubating dose of vecuronium followed immediately the induction agent, thiopental sodium (5 mg/kg) . Orotracheal intubation was done 90 sec after the intubating dose. Intubation conditions and TOF responses were evaluated. The results are as follows 1 ) After the priming dose, twenty-six patients complained of minor aide effects. 2) There was no difficultly in intubation. Forty-mix patients(94%) were distributed in 1 and 2 grade of intubation condition. 3) In the grade 1, female patients were more distrihuted than male patients(p<0.05). 4) The responses of TOF at the intubation were 44.54+/-38,92%. There were wide indivi-dual variances. 5) The internal between the intubating dose and the disappeared twitch response was 3.72+/-2.73 min. The first twitch reappeared 26.04+/-10.86 min. after the intubating dose. In conclusion, we recommend that the divited doses of vecuronium(the priming and int-ubating doses, 0.01 mg/kg and 7.1 mg/kg, respectively) for the rapid sequence endotracheal intubation may be applied adequately in some clinical situations.