THIOPENTAL OR ETOMIDATE FOR RAPID-SEQUENCE INDUCTION WITH ROCURONIUM

We have assessed the effect of the choice of i.v. induction agent on i ntubation conditions, 60 s after administration of rocuronium 0.6 mg k g(-1) We studied 60 adult patients, allocated randomly to one of two g roups. Anaesthesia was induced with alfentanil 10 mu g kg(-1) followed by thiopental 5 mg kg(-1) (AT-R group; n=30) or etomidate 0.3 mg kg(- 1) (AE-R group; n=30). Both groups received rocuronium 0.6 mg kg(-1). Laryngoscopy was started 60 s later and intubation conditions were eva luated according to a standard score, which considered ease of laryngo scopy, condition of the vocal cords and reaction to intubation. In the AT-R group, overall intubation conditions were scored as excellent in 20 patients, good in nine and fair in the remaining patient. In the A E-R group, overall intubating conditions were excellent in 24 and good in six patients. The difference between the two groups was not signif icant. Of the three components of the intubation score assessed, respo nse to intubation stimulus was significantly less pronounced in group AE-R compared with group AT-R (P<0.05): group AE-R, no reaction in 24 patients, slight diaphragmatic movement in five and mild coughing in o ne patient; group AT-R, no reaction in 13, slight diaphragmatic moveme nt in 14, mild coughing in two and severe coughing in one patient. We conclude that etomidate as part of an induction regimen containing alf entanil and rocuronium attenuated the reaction to intubation to a grea ter extent than thiopental.