لوله گذاري زودهنگام تراشه با شل كننده عضلاني غيردپلاريزان و اضافه دوز تيوپنتال سديم

EARLY TRACHEAL INTUBATION WITH NONDEPOLARIZATION MUSCLE RELAXANTS AND ADDITIONAL DOSE OF THIOPENTAL SODIUM

OBJECTIVE: One of the most important duties of an anesthetist is keeping the airways open. Since there is a contraindication of succinylcholine in some cases, tracheal intubation is done by nondepolarization muscle relaxants with a delay of 4 min. In this study, this delay time has been decreased to 30 seconds with an additional dose of thiopental (20%) and atracorium injection. METHODS: This study was conducted on 100 cases in A.S.A class I of American society of anesthesiologists classification with patients of 15-45 years of age. They were randomly divided into two groups (each group with 50 cases). In control group after premedication, in first group anesthesia started with atracorium (0.6mg/kg.) and then with thiopental sodium (5mglkg) and intubation was done after 4 min of ventilation. In case group after administration of the same premedication and atracorium, an additional dose of thiopental sodium (20%) was injected and tracheal intubation was done after 30 seconds. Heart beat and blood pressure at 0 minute after premedication. at induction of anesthesia and tracheal intubation and after 5 min with intubation were monitored. The quality and tube tolerance were recorded and analysed statistically as well. FINDINGS: In both groups after induction of anesthesia. systolic and diastolic blood pressure decreased and heart rate increased. In spite of changes of blood pressure in case group there was not a statistically significant difference. intubation was easily performed on 92% of patients in case group and 96% in control group and also 20% in case group and 12% in control group did not tolerate the endotracheal tube without any significant difference. CONCLUSION: A 4 minute delay for intubation by atracorium can be decreased to 30 seconds with an additional dose of thiopental. This method can be used for patients with contraindication of succinylcholine use and also it can decrease the side effects of longtime P.P.V mask ventilation and and anesthesia bag.