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Related Experiment Videos

Thiopental or etomidate for rapid sequence induction with rocuronium

T Fuchs-Buder1, H J Sparr, T Ziegenfuss

  • 1Department of Anaesthesia and Intensive Care Medicine, University of Saarland, Homburg/Saar, Germany.

British Journal of Anaesthesia
|June 26, 1998
PubMed
Summary

Etomidate, when used with alfentanil and rocuronium, provides better intubation conditions by significantly reducing patient response to intubation compared to thiopental.

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Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Intubation conditions are crucial for patient safety during anesthesia.
  • The choice of intravenous induction agent can influence intubation outcomes.

Purpose of the Study:

  • To compare the effects of etomidate versus thiopental as induction agents on tracheal intubation conditions when combined with alfentanil and rocuronium.

Main Methods:

  • Sixty adult patients were randomly assigned to receive anesthesia induced with either alfentanil and thiopental (AT-R group) or alfentanil and etomidate (AE-R group).
  • All patients received rocuronium 0.6 mg/kg, and intubation conditions were assessed 60 seconds later using a standardized scoring system.
  • The score evaluated ease of laryngoscopy, vocal cord condition, and patient response to intubation.

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Main Results:

  • Overall intubation conditions were excellent or good in the majority of patients in both groups (AT-R: 29/30, AE-R: 30/30), with no significant difference between groups.
  • However, the AE-R group showed a significantly less pronounced response to the intubation stimulus compared to the AT-R group (P < 0.05).
  • Specifically, fewer patients in the AE-R group exhibited reactions like diaphragmatic movement or coughing.

Conclusions:

  • Etomidate, as part of an anesthetic induction regimen with alfentanil and rocuronium, attenuates patient response to intubation more effectively than thiopental.
  • Both etomidate and thiopental provide acceptable intubation conditions when used in this combination, but etomidate offers a superior reduction in patient movement and reflexes.