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Rapid sequence induction using vecuronium.

V E Kunjappan, E M Brown, G D Alexander

    Anesthesia and Analgesia
    |May 1, 1986
    PubMed
    Summary
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    A 15 mcg/kg priming dose with a 100 mcg/kg total dose of vecuronium provides optimal conditions for rapid sequence induction and tracheal intubation, comparable to succinylcholine.

    Area of Science:

    • Anesthesiology
    • Pharmacology
    • Critical Care Medicine

    Background:

    • Rapid sequence induction (RSI) requires potent neuromuscular blocking agents for effective tracheal intubation.
    • Succinylcholine is commonly used but has contraindications.
    • Vecuronium offers an alternative with a favorable side effect profile.

    Purpose of the Study:

    • To determine the optimal priming and total dosage of vecuronium for RSI.
    • To compare vecuronium's efficacy against succinylcholine for intubation.
    • To evaluate onset time, intubating conditions, and duration of action.

    Main Methods:

    • Seventy patients undergoing RSI were studied.
    • Various priming and total dose regimens of vecuronium were administered.

    Related Experiment Videos

  • Vecuronium doses were compared to succinylcholine (1.5 mg/kg).
  • Onset times, intubating conditions, and duration were analyzed.

    • Main Results:

    • A priming dose of 10 mcg/kg vecuronium yielded good intubation conditions but longer onset times than succinylcholine.
    • A priming dose of 15 mcg/kg with a 100 mcg/kg total dose resulted in excellent intubating conditions and onset times comparable to succinylcholine.
    • Vecuronium demonstrated fewer cardiovascular side effects and a shorter duration than pancuronium.

    Conclusions:

    • The recommended vecuronium regimen (15 mcg/kg priming, 100 mcg/kg total) is effective for RSI when succinylcholine is contraindicated.
    • Vecuronium is a suitable alternative to pancuronium for RSI due to its safety and efficacy profile.