Anesth Pain Med.  2017 Jan;12(1):47-51. 10.17085/apm.2017.12.1.47.

Effects of thiopental sodium, ketamine, and propofol on the onset time of rocuronium in children

• Jung KT
• Kim HJ
• Choi YJ
• Hur DK
• Kang JH
• An TH

• KMID: 2369666
• DOI: http://doi.org/10.17085/apm.2017.12.1.47

Abstract

BACKGROUND
In emergency condition, failure in securing airway is a common and serious reason of pediatric death. Rapid intubation is required to minimize physiologic complication in children due to airway failure. Rapid loss of consciousness and rapid onset of neuromuscular blocking agent are necessary for the rapid sequence intubation. In this study, we compared the effects of thiopental sodium, ketamine, and propofol (drugs commonly used to induce anesthesia in children) on the onset time of rocuronium. We also compared the effects of these anesthesia induction drugs on intubation condition and their duration of action.
METHODS
A total of 89 patients undergoing various elective surgeries were enrolled and allocated to the following three groups according to the anesthesia induction drug: 1) Group T, thiopental sodium; 2) Group P, propofol; and 3) Group K, ketamine. After loss of consciousness, neuromuscular monitoring was performed and rocurunium 0.6 mg/kg was administered. Onset time and duration of action of rocuronium were measured. Intubation condition was recorded with a tracheal intubation scoring system. Hemodynamic changes were observed before induction until 5 min after endotracheal intubation.
RESULTS
The onset time of rocuronium in group K (39.9 s) was significantly faster than that in group T (61.7 s) or group P (50.7 s). There was no significant difference in duration of action of rocuronium or intubation condition among the three groups.
CONCLUSIONS
Ketamine can decrease the onset time of rocuronium significantly compared to thiopental sodium or propofol.

Keyword

Ketamine; Propofol; Rocuronium; Thiopental sodium

MeSH Terms

Anesthesia
Child*
Emergencies
Hemodynamics
Humans
Intubation
Intubation, Intratracheal
Ketamine*
Neuromuscular Blockade
Neuromuscular Monitoring
Propofol*
Thiopental*
Unconsciousness
Ketamine
Propofol
Thiopental

Figure

• 

  Fig. 1 Values are mean ± SD. Sequential changes of mean arterial pressure (MAP). MAP was higher in group K than that in group P or group T after the injection of anesthetics. Group T: thiopental sodium, Groups P: propofol, Group K: ketamine. T1: baseline before induction, T2: 1 min after injection of anesthetics for induction, T3: just before endotracheal intubation, T4: 1 min after endotracheal intubation, T5: 2 mins after endotracheal intubation, T6: 3 mins after endotracheal intubation, T7: 4 mins after endotracheal intubation, T8: 5 mins after endotracheal intubation. *P < 0.05 compared to group T. †P < 0.05 compared to group P.

• 

  Fig. 2 Values are mean ± SD. Sequential changes of heart rate (HR). HR was higher in group K than that in group P or group T at 2 min after endotracheal intubation. Group T: thiopental sodium, Groups P: propofol, Group K: ketamine. T1: baseline before induction, T2: 1 min after injection of anesthetics for induction, T3: just before endotracheal intubation, T4: 1 min after endotracheal intubation, T5: 2 mins after endotracheal intubation, T6: 3 mins after endotracheal intubation, T7: 4 mins after endotracheal intubation, T8: 5 mins after endotracheal intubation. *P < 0.05 compared to group T. †P < 0.05 compared to group P.

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