Comparison of sevoflurane and propofol with rocuronium for modified rapid-sequence induction of anaesthesia

We compared the use of sevoflurane and propofol with three different doses of rocuronium for modified rapid-sequence induction of anaesthesia. One hun dred and forty adult patients were randomly allocated to have a rapid-seque nce intravenous induction with propofol 2-3 mg.kg(-1) (group P) or an inhal ational induction with sevoflurane 8% in oxygen, using a vital capacity tec hnique (group S). Following loss of the eyelash reflex, cricoid pressure wa s applied and 20 patients in each group were administered rocuronium 0.3 (g roups P/0.3 and S/0.3), 0.45 (groups P/0.45 and S/0.45) or 0.6 (groups P/0. 6 and S/0.6) mg.kg(-1) An additional 10 patients in each group received onl y saline placebo in place of the muscle relaxant (groups P/Saline and S/Sal ine). Laryngoscopy was started 60 s later and intubating conditions evaluat ed by a blinded anaesthetist according to a standard scoring system. Intuba ting conditions were acceptable in one patient and no patient. respectively following induction with sevoflurane and propofol without the muscle relax ant. The conditions were acceptable in 30, 55 and 90% of subjects with sevo flurane induction, and in 45, 80 and 90% of subjects with propofol inductio n following 0.3, 0.45 and 0.6 mg.kg(-1) of rocuronium, respectively (no sig nificant difference for each dose of rocuronium). The: present study shows that intubating conditions during a rapid-sequence: induction using rocuron ium 0.6 mg.kg(-1) following induction of anaesthesia with sevoflurane or pr opofol are similar.