Comparison of Methods to Facilitate Rapid Sequence Intubation

Seoul National University Bundang Hospital110 enrolled

Overview

In this study, methods which are known for facilitating rapid sequence intubation or accelerating rocuronium (Roc)onset are compared including magnesium (Mg), ketamine pretreatment, large dose rocuronium and priming.

Patients are pretreated with Mg, ketamine, or priming dose Roc. Two groups do not receive pretreatment, but are given Roc 0.6 mg/kg or 0.9 mg/kg.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Masking

QUADRUPLE

Enrollment

110

Conditions

Intubating Condition

Interventions

Magnesium SulfateDRUG

Patients receive MgSO4 50 mg/kg for 10 min before injection of Roc 0.6 mg/kg.

KetamineDRUG

patients receive ketamine 0.5 mg/kg 2 min before Roc injection.

rocuroniumDRUG

Patients receive Roc 0.06 mg/ kg as a priming dose 3 min before injection of Roc 0.54 mg/kg.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * age 18 - 65 years, * ASA 1 - 2, * patients scheduled for elective surgery under general anesthesia, * BMI 18.5-24.9 kg/m2 * Mallampati class I-II Exclusion Criteria: * neuromuscular disorder, * cardiac/hepatic/renal insufficiency, * pregnant. * anticipated difficult airway * medications that influence neuromuscular transmission

Locations (1)

Seoul National University Bundang hopital

Seongnam-si, Gyeonggi-do, South Korea

Outcomes

Primary Outcomes

Intubation score

Patients are tracheally intubated, and intubation scores(poor, good,excellent)are rated.

Time frame: participants will be followed at the time point of intubation, an expected average of 70 sec from the start of rocuronium injection.

Secondary Outcomes

Roc duration

Time from the start of rocuronium injection until reappearance of two muscle twitches in TOF stimulations is measured, using ToF-Watch sx.

Time frame: participants will be followed when TOF count reaches two, an expected average of 40 min.

Roc onset

Time from the start of rocuronium injection until TOF count=0 using TOF-Watch sx.

Time frame: participants will be followed when TOFcount =0 within an expected average of 4 min from the start of rocuronium injection.

Hemodynamic variables

Mean arterial pressure (MAP)and heart rate (HR) are measured at baseline, before intubation, and 1, 2, 3, 4, 5 min after intubation.

Time frame: participants will be followed at baseline, before and for 5 min after the intubation, an expected average of 8 min after the start of anesthetic induction.

TOF% at intubation

neumeric value expressed as %, displayed on the monitor of TOF watch-Sx in TOF stimulation (ex. 5% on the display means 95% suppression of T1)

Time frame: participants will be followed at the time point of intubation, an expected average of 70 sec from the start of rocuronium injection.

Data from ClinicalTrials.gov

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