[Conditions of intubation with vecuronium using a priming principle]

Abstract

Different protocols based on the priming principle have been proposed so as to enable rapid tracheal intubation with vecuronium. The conditions of such an intubation have been assessed in 47 ASA I or ASA II patients, with an empty stomach, using a priming dose of 0.01 mg X kg-1, followed by a second injection of 0.1 mg X kg-1 after a short interval of 4 min. An intubation score was defined using a nerve stimulator (Relaxograph Datex), by measuring the twitch in comparison with a reference value, as well as time before intubation for four groups of patients. Good intubation scores with a twitch approaching 50% was obtained in all and, in the same way, for a fifth group of patients, intubated in an arbitrary manner 60 s after the second dose of vecuronium. These results can be compared with those obtained by other authors using a different protocol. Nevertheless, this method does not match perfectly that of suxamethonium. Taking into account the side-effects and above all the inhalation risk existing after a priming dose, is it opportune to use this technique for the anaesthesia of a patient with a full stomach?