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Titolo:
Rapacuronium 2.0 or 2.5 mg kg(-1) for rapid-sequence induction: comparisonwith succinylcholine 1.0 mg kg(-1)
Autore:
Blobner, M; Mirakhur, RK; Wierda, JMKH; Wright, PMC; Olkkola, KT; Debaene, B; Pendeville, P; Engbaek, J; Rietbergen, H; Sparr, HJ;
Indirizzi:
Tech Univ Munich, Klinikum Rechts Isar, Anasthesiol Klin, Dept Anaesthesia, D-81675 Munich, Germany Tech Univ Munich Munich Germany D-81675 sthesia, D-81675 Munich, Germany Queens Univ Belfast, Belfast, Antrim, North Ireland Queens Univ Belfast Belfast Antrim North Ireland , Antrim, North Ireland Univ Groningen Hosp, Groningen, Netherlands Univ Groningen Hosp Groningen Netherlands Hosp, Groningen, Netherlands Univ Newcastle Upon Tyne, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England Univ Newcastle Upon Tyne Newcastle Upon Tyne Tyne & Wear England NE1 7RU Univ Helsinki, Cent Hosp, Helsinki, Finland Univ Helsinki Helsinki Finland v Helsinki, Cent Hosp, Helsinki, Finland Inst Gustave Roussy, Paris, France Inst Gustave Roussy Paris FranceInst Gustave Roussy, Paris, France Catholic Univ Louvain, Clin Univ St Luc, Brussels, Belgium Catholic Univ Louvain Brussels Belgium n Univ St Luc, Brussels, Belgium Herlev Univ Hosp Kobenhavn, Copenhagen, Denmark Herlev Univ Hosp Kobenhavn Copenhagen Denmark havn, Copenhagen, Denmark Organon Tekn BV, Boxtel, Netherlands Organon Tekn BV Boxtel NetherlandsOrganon Tekn BV, Boxtel, Netherlands Leopold Franzens Univ, Innsbruck, Austria Leopold Franzens Univ Innsbruck Austria anzens Univ, Innsbruck, Austria
Titolo Testata:
BRITISH JOURNAL OF ANAESTHESIA
fascicolo: 5, volume: 85, anno: 2000,
pagine: 724 - 731
SICI:
0007-0912(200011)85:5<724:R2O2MK>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTUBATING CONDITIONS; ADDUCTOR POLLICIS; ADULT PATIENTS; NEUROMUSCULAR BLOCKADE; MUSCLE-RELAXANT; ROCURONIUM; ANESTHESIA; SUXAMETHONIUM; ORG-9487; HUMANS;
Keywords:
anaesthesia, rapid sequence induction; anaesthesia, intubation; neuromuscular block, rapacuronium; neuromuscular block, succinylcholine;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Blobner, M Tech Univ Munich, Klinikum Rechts Isar, Anasthesiol Klin, Dept Anaesthesia, Ismaninger Str 22, D-81675 Munich, Germany Tech Univ Munich Ismaninger Str 22 Munich Germany D-81675 many
Citazione:
M. Blobner et al., "Rapacuronium 2.0 or 2.5 mg kg(-1) for rapid-sequence induction: comparisonwith succinylcholine 1.0 mg kg(-1)", BR J ANAEST, 85(5), 2000, pp. 724-731

Abstract

The purpose of this nine-centre study in 602 patients was to show that thefrequency of acceptable intubating conditions after rapacuronium 2.0 or 2.5 mg kg(-1) is not more than 10% lower than the frequency after succinylcholine 1.0 mg kg(-1) during rapid-sequence induction of anaesthesia with fentanyl 1-2 mug kg(-1) and thiopental 2-7 mg kg(-1). Laryngoscopy and intubation were carried out 60 s after administration of muscle relaxant by an anaesthetist blinded to its identity. Intubating conditions were clinically acceptable (excellent or good) in 91.8% of patients given succinylcholine and in 84.1 and 87.6% of patients given rapacuronium 2.0 and 2.5 mg kg(-1) respectively. With respect to the percentage of clinically acceptable intubating conditions, the estimated difference (and the upper limit of the one-sided 97.5% confidence interval) between succinylcholine and rapacuronium 2.0 mg kg(-1) was 7.8 (14.4)% and between succinylcholine and rapacuronium 2.5 mg kg(-1) it was 4.0 (10.2)%. For both comparisons, the upper limit of the one-sided confidence interval exceeded the predefined 10% difference. Hence,it could not be demonstrated that the intubating conditions with either ofthe two doses of rapacuronium were not inferior to those with succinylcholine 1.0 mg kg(-1). The increase in heart rate was significantly greater during the first 5 min in the rapacuronium groups, but the arterial pressure increased significantly only in the succinylcholine group (P<0.001). Respiratory side-effects were observed in 4.0, 13.5 and 18.5% of patients after succinylcholine and rapacuronium 2.0 and 2.5 mg kg(-1) respectively (P<0.05). As the non-inferiority of intubating conditions after rapacuronium 2.0 and2.5 mg kg(-1) could not be proven, succinylcholine should be considered the neuromuscular blocking agent that provides better intubating conditions for rapid-sequence induction.

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Documento generato il 05/04/20 alle ore 03:59:12