Abstract

Objectives: We investigated the effects of induction technique on intubation conditions with thiopental, propofol, or etomidate followed by an opioid and rocuronium.

Patients and Methods: Intubation conditions were assessed in three groups each consisting of 20 patients. Anesthesia induction was performed by either thiopental (5 mg/kg), propofol (2 mg/kg), or etomidate (0.3 mg/kg) followed by alfentanil (10 µg/kg) and rocuronium (0.9 mg/kg). Laryngoscopy was started 45 seconds after the administration of the neuromuscular blocker and intubation was performed within 60 seconds. Intubation conditions were rated according to the criteria by Cooper et al, which considered ease of laryngoscopy, condition of the vocal cords, and reaction to intubation.

Results: Overall intubation conditions were as follows: excellent in 12, good in five, and fair in three patients; excellent in 17 and good in three patients; excellent in 16 and good in four patients in the thiopental, propofol, and etomidate groups, respectively. No significant differences were found between the three groups with respect to ease of laryngoscopy and condition of the vocal cords (p>0.05). However, response to intubation and overall intubation conditions were significantly better in the propofol and etomidate groups compared with those of thiopental (p<0.05).

Conclusion: The results suggest that propofol or etomidate can be used with alfentanil and rocuronium for intubation within 60 seconds under rapid induction requirements.