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The effect of atropine on heart rate with rapid sequence induction in neonates

Author: Ahmed Haki Ismael Al-Rawee
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2012 Volume: 11 Issue: 2 Pages: 53-57
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: neonates experience physiological responses toendotracheal intubation, including bradycardia and oxygen desaturation.The bradycardia may be associated with severe hemodynamicdisturbances like significant hypotension which may threaten patient'ssafety.Aims: To determine the effectiveness of single dose IV atropine, 5minutes before induction of anesthesia on reflex bradycardia tolaryngoscopy in sick neonate baby.Patients and Methods: In a randomized double blinded, placebocontrolled clinical trial, thirty neonates aged 1-10 days, term, 2.5-3.5kgand from both sexes, were enrolled to receive 0.02mg/kg IV atropine(n=15), as study group and placebo group had received equivalentvolume of normal saline five minutes before induction of anaesthesia(n=15), as control group. The induction technique was the same in allpatients. The incidence of bradycardia just after intubation wasrecorded.Results: data analyses showed that the overall incidence of bradycardiajust after intubation in the study group was significantly lower than thecontrol group.Conclusions: A single dose IV atropine five minutes before induction ofanaesthesia in neonate baby significantly decreases the incidence ofbradycardia after intubation.


Article
Rapid Sequence Induction using Rocuronium in Adult Patients

Author: Hasan Sarhan*, Ahmed Saeed Abdullah**, Ahmed Mohammed Hussein***
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 4 Pages: 429-436
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Several studies using rocuronium as an alternative to suxamethonium for endotracheal intubating conditions in rapid sequence induction are available in literature, all claiming obvious advantages, but intubating conditions after suxamethonium and rocuronium have not been assessed in our hospitals yet.OBJECTIVE: The aim of this study was to assess the efficacy of rocuronium for rapid sequence induction by comparing the endotracheal intubating conditions with suxamethonium, following induction with sodium thiopentone as the sole induction agent in elective, otherwise healthy, adult patients.MATERIALS AND METHODS:The patients were divided into two groups, each consisting of 40 patients: group A patients received rocuronium bromide 0.6 mg/kg IV, and group B patients received suxamethonium chloride 1.5 mg/kg IV. In both groups, jaw relaxation and vocal cord relaxation were considered for atraumatic laryngoscopy at 60 seconds . Induction of anesthesia achieved with thiopentone as a sleeping dose for all patients.RESULTS: All the patients in the suxamethonium group have excellent intubating conditions, while in the rocuronium group, 90% of the patients were excellent and 10% were good regarding the intubating conditions. CONCLUSION: It is concluded from this study that intubation can be performed under good to excellent conditions at 60 seconds after a bolus dose of rocuronium of 0.6 mg/kg. The result of this study indicates that this nondepolarizing neuromuscular blocking agent may be considered as a valuable alternative to suxamethonium for rapid sequence induction, i.e., within 60 seconds, even after induction with thiopentone as the sole anesthetic agent.

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