Effectiveness of the timing principle with high-dose rocuronium during rapid sequence induction with lidocaine, remifentanil and propofol

Suzuki, Takahiro; Aono, Mayu; Fukano, Naoko; Kobayashi, Makiko; Saeki, Shigeru; Ogawa, Setsuro
April 2010
Journal of Anesthesia;2010, Vol. 24 Issue 2, p177
Academic Journal
The main purpose of this study was to examine the effectiveness of the timing principle with 1 mg kg−1 rocuronium for rapid sequence intubation. As secondary outcomes, propofol and lidocaine with or without remifentanil were examined to note their effects on the cardiovascular responses to laryngoscopy and intubation. Thirty patients were randomly allocated to one of two groups of 15 patients each: a lidocaine-treated group (L) and a lidocaine/remifentanil-treated group (LR). Thirty seconds after lidocaine 1 mg kg−1 with or without infusion of remifentanil 1 μg kg−1 min−1, all patients received a bolus of rocuronium 1 mg kg−1. Shortly afterwards, patients were given propofol 2–2.5 mg kg−1. Intubating conditions and cardiovascular responses were observed 60 s after rocuronium. The time to spontaneous recovery of visible train-of-four (TOF) counts of 4 was observed at the thumb during 1.0–1.5% end-tidal sevoflurane and remifentanil anesthesia. All patients had excellent or good intubating conditions. Hypertension and tachycardia during laryngoscopy were well prevented in group LR, whereas they were significantly observed in group L. The times to reappearance of TOF counts of 4 were comparable in all groups [mean (SD); 63.6 (8.6) min in group L and 63.5 (11.6) min in group LR]. Application of the timing principle with 1 mg kg−1 rocuronium is beneficial for rapid tracheal intubation. Co-administered lidocaine, remifentanil and propofol can definitely suppress cardiovascular responses during laryngoscopy and intubation.


Related Articles

  • Effects of Esmolol, Lidocaine and Fentanyl on Haemodynamic Responses to Endotracheal Intubation. Ugur, Bakiye; Ogurlu, Mustafa; Gezer, Erdal; Aydin, Osman Nuri; Gürsoy, Feray // Clinical Drug Investigation;2007, Vol. 27 Issue 4, p269 

    Background and objective: Predicting the haemodynamic changes that may result in myocardial ischaemia for patients undergoing laryngoscopy and tracheal intubation will help to avoid events that trigger ischaemia and allow immediate treatment. The objective of this study was to compare the...

  • Attenuation Of The Hemodynamic Response To Endotracheal Intubation: Fentanyl Versus Lignocaine. Malde, Anila D.; Sarode, Vineet // Internet Journal of Anesthesiology;2007, Vol. 12 Issue 1, p1 

    Aim: A double blind, randomized, controlled, study was designed to compare the efficacy of single bolus doses of Fentanyl (2µg/kg) or Lignocaine (1.5 mg/kg) for attenuation of pressor response to laryngoscopy and endotracheal intubation (ETI). Methods: Ninety patients received either fentanyl...

  • The management of epistaxis: Staunching the flow. Douglas, Richard // New Zealand Doctor;7/6/2016, p26 

    The article focuses on the management of epistaxis in the general practice setting. Topics discussed include Hypertension and tachycardia as factors that promote continued epistaxis; topical lignocaine solution and adrenaline used to stop the bleeding; and need to send patients to the nearest...

  • Effect of tracheal lidocaine on intubating conditions during propofol-remifentanil target-controlled infusion without neuromuscular blockade in day-case anesthesia. Jin-Soo Kim; Dae-Hee Kim; Han Bum Joe; Chang Keun Oh; Jong-Yeop Kim // Korean Journal of Anesthesiology;Nov2013, Vol. 65 Issue 5, p425 

    Background: Lidocaine is a useful intravenous and topical adjunct to facilitate tracheal intubation. We evaluated the effect of tracheal lidocaine on tracheal intubating conditions without neuromuscular blocking agent and hemodynamics during anesthesia induction with propofol and remifentanil...

  • Effect of lidocaine (40 mg) mixed to prevent injection pain of propofol on the intubating conditions and onset time of rocuronium. Sang Young So; Kim, Yoon-Hee; Ko, Young-Kwon; Sang Il Park; Hae Jin Pak; Woo Suk Jung // Korean Journal of Anesthesiology;Jan2013, Vol. 64 Issue 1, p29 

    Background: To analyze how lidocaine 40 mg mixed prevents injection pain of propofol affects the onset time of rocuronium, tracheal intubating conditions and intubation related hemodynamic changes. Methods: This study consisted of 70 patients with an American Society of Anesthesiologists (ASA)...

  • MaraÅŸ Otu Kullanan Hastadaki Anestezi Deneyimimiz. Baş, Sema Şanal; Özlü, Onur // Turkish Journal of Anesthesia & Reanimation;Apr2013, Vol. 41 Issue 2, p68 

    MaraÅŸ powder (MP) is widely used instead of cigarette smoking in the south-eastern region of our country. MP is at least as harmful as tobacco to the cardiovascular system. Patients using MP are prone to show exaggerated hemodynamic responses such as tachycardia and hypertension to...

  • Comparison of the efficacy of dexmedetomidine with that of esmolol in attenuating laryngoscopic and intubation response after rapid sequence induction. Yallapragada, Srivishnu Vardhan; Vidadala, Krishna Santh; Vemuri, Nagendra Nath; Shaik, Mastan Saheb // Anesthesia: Essays & Researches;Sep-Dec2014, Vol. 8 Issue 3, p383 

    Context: Laryngoscopy and tracheal intubation produce sympathetic overdrive by catecholamine release resulting in hypertension and tachycardia. Various agents are being tried to combat the intubation response over years. Aims: This study is aimed at comparing dexmedetomidine which is a highly...

  • Sevoflurane and airway anaesthesia. George, L. // Anaesthesia & Intensive Care;May2012, Vol. 40 Issue 3, p559 

    A letter to the editor is presented in response to the article "Optimum bolus dose of propofol for tracheal intubation during sevoflurane induction without neuromuscular blockade in children" that was previously published.

  • Spatiotemporal dynamics of reentrant ventricular tachycardias in canine myocardial infarction: pharmacological modulation. Helie, Francois; Vinet, Alain; Cardinal, Rene // Canadian Journal of Physiology & Pharmacology;May2003, Vol. 81 Issue 5, p413 

    Presents a study which investigated in canine preparations the implications of procainamide and lidocaine's differential kinetic properties on the cycle length dynamics and stability of activation patterns at the onset of reentrant ventricular tachycarias. Methods; Results; Discussion.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics