The Effects of Vecuronium Bromide in Divided Dose on Endotracheal Intubation

Kim, Dong Yeon; Lee, Chi Hyo; Lee, Choon Hi

Abstract

Succinylcholine chloride is ordinarily the muscle relaxant of choice for rapid endotracheal intubation, but may produce myalgia, increase in intragastric pressure, increase in intraocular pressure, and it may be associated with malignant hyperthermia and hyperkalemia. Many investigators have tried to find an alternative drug for succinylcholine chloride. Foldes reported that the onset can be shortened by the administration of a subparalyzing dose of vecuronium bromide a nondepolarizing intermediate-acting muscle relaxant, prior to its intubating dose. This has been termed "the priming principle",. Mehta et al, Lennon et al and Schwarz reported similar results. These investigators studied to identify an optimal priming dose, priming interval (the time from the priming dose to the intubating dose) and intubating dose of vecuronium bromide, to perform a rapidsequence induction of anesthesia. We studied 50 healthy adult patients, and results are 1) Group IV (a priming dose of 0.02 mg/kg, a priming interval of 4 min and an intuating dose of 0. 1 mg/kg) had better intubating condition than the control group. 2) The groups with divided doses had significantly shorter onset time compared to the control group (0.1 mg/kg without prime dose). 3) Group II and IV (priming dose 0.02 mg/kg) had shorter onset time compared to group I and III (priming dose 0.01 mg/kg), but the difference was not significant. 4) Group III and IV (priming interval of 4 min) had shorter onset time compared to group I and II (priming interval of 2 min), but the difference was not significant. In conclusion, group IV (priming dose of 0.02 mg/kg and priming interval of 4 min) had the shortest onset time and provided the best intubating condition.