Influence of an Induction Technique on Intubating Conditions in Adult Patients After Rocuronium : a Comparison of Rropofol and Propofol-Ketamine for Rapid Sequence Induction of Anesthesia
Kaewnopparat T*, Uakritdathikarn T
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90111
Introduction : The effect of a neuromuscular blocking agent can be accelerated by many factors such as increased dose or priming technique. Hemodynamic factors such as cardiac output, circulation time and muscle perfusion have been shown to have an effect on the onset of blockade in previous studies. An induction agent which maintains blood pressure and cardiac output may an important factor in speeding up the onset of blockade and improving the intubating conditions of the patients. Objective : To compare intubating conditions and hemodynamic changes after induction with a propofol-ketamine combination or propofol alone, followed by rocuronium 0.6 mg/kg at 60 seconds. Materials and methods : One hundred adult patients with ASA class I-II and age of 15-65 years were randomly assigned to receive either propofol 1 mg/kg and ketamine 0.5 mg/kg in combination (PK group) or propofol 2 mg/kg (P group). The study was double-blinded, and anesthesia and timing of injections were standardized to the study drug and rocuronium 0.6 mg/kg. Tracheal intubation was attempted at 60 s after the relaxant and the intubating condition was graded as excellent, good, fair or poor by an experienced anesthetist. Results : There was no significant difference in the proportion of excellent intubating conditions between the PK group (60%) and the P group (62%) (p>0.05). Mean arterial pressure and heart rate were maintained at pre-induction levels in both groups. Conclusion : The study demonstrated the similar intubating condition usint rocuronium after induction with propofol-ketamine and propofol alone. 
วิสัญญีสาร ปี 2548, January-March ปีที่: 31 ฉบับที่ 1 หน้า 297-306
Propofol, Induction technique, Intubating condition, Ketamine, Rocuronium