Rocuronium is suitable for rapid induction within 60-90 seconds and its effect last 24-40 minute after single bolus injection. For outpatient surgery with short operation time, low dose rocuronium is frequently used for rapid recovery at the expense of compromised intubating condition. For better intubating condition, ketamine can be used. However, appropriate dose of ketamine with low dose rocuronium is not established yet. This study, 3 different doses of ketamine with low dose rocuronium will be compared for appropriate intubating condition.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Masking
TRIPLE
Enrollment
60
Low dose rocuronium (0.3 mg/kg) will be injected after induction of anesthesia with ketamine.
ketamine 1 mg/kg will be injected for induction of anesthesia
ketamine 1.5 mg/kg will be injected for induction of anesthesia
Intubation Condition
5 variables will be individually evaluated though 3 point scale (excellent, good, poor). If all variables are graded as excellent, intubation condition will be excellent. If at least 1 variable is poor, it will be reported as poor. Otherwise, it will be reported as good. 1. Laryngoscope easiness 2. Vocal cord position 3. Vocal cord movement 4. Movement of limb 5. Coughing
Time frame: during and after intubation, about 2 minute
heart rate
heart rate will be recorded.
Time frame: 1. 1 min before induction 2.1 min after ketamine injection 3. 1min after intubation 4. 5 min after intubation 5. 10 min after intubation
time for extubation
Time frame: from the end of surgery to extubation, within 10 min
emergence agitation (4 points scale)
4 points scale 1: calm 2. cry but manageable 3. cry, not manageable 4. excitation
Time frame: 5 min after postanesthesia care unit (PACU) admission
PACU time
Time frame: from PACU admission to discharge, about 30 min
severity of vomiting
severity(0-10)
Time frame: 1. 1 min after PACU admission 2. 30 min after PACU admission
Analgesic requirements (mg/kg)
if pain score exceed 3, fentanyl will be introduced. The total dose of fentanyl injection will be recorded.
Time frame: during PACU stay, about 30 min
Desaturation
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ketamine 2 mg/kg will be injected for induction of anesthesia
pulseoximeter will be applied and peripheral oxygen saturation less than 94 will be recorded.
Time frame: during PACU stay, about 30 min
blood pressure
blood pressure will be recorded
Time frame: 1. 1 min before induction 2.1 min after ketamine injection 3. 1min after intubation 4. 5 min after intubation 5. 10 min after intubation
frequency of vomiting
Time frame: 1. 1 min after PACU admission 2. 30 min after PACU admission