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Korean J Anesthesiol > Volume 20(4); 1987 > Article
Korean Journal of Anesthesiology 1987;20(4):456-461.
DOI: https://doi.org/10.4097/kjae.1987.20.4.456   
Clinical Evaluation of Vecuronium in Divided Doses for Endotracheal Intubation .
Hae Ran Kim, Yang Sik Shin, Won Oak Kim, Kwang Won Park, Chung Hyun Cho
Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.
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.
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