Emprego do pancuronio e alcuronio em doses de relaxamento muscular para intubação traqueal

AUTOR(ES)
DATA DE PUBLICAÇÃO

1992

RESUMO

The use of competitive neuromuscular blockers in fractional doses is indicated as an alternative technique to accelerate the beginning of blockage and facilitate the quick traqueal intubation. The effects of different priming-doses and the single injection of a total dose of pancuronium and alcuronium on the amplitude of muscular responses, conditions of muscular relaxation for traqueal intubation and cardiocirculatory alterations were studied. We analysed eighty patients, divided into two groups, according to the neuromuscular blocker used (Group I - pancuronium 0,008 mg.kg-1 and Group II - alcuronium 0,2 mg.kg-1). We then divided the Groups into subgroups according to the priming-doses (subgroup A=1/3, subgroup B=1/5 and subgroup C=1/8 of the total dose) and the single injection (subgroup "control"). An interval of one minute was determined between the priming-dose and complementary dose and between the latter and traqueal intubation. Regarding the subgroup "control", traqueal intubation. Was performed two minutes after agent injection. We observed, one minute after priming-doses, a variable reduction in the amplitude of muscular responses and a reduction in more than 50%, one minute after single injection of both agents. The percentages responses at intubation were traqueal subgroups. Satisfactory traqueal intubation conditions were observed in 87.5% and 92.5% of the patients of Groups I and II respectively,. In the subgroups were priming doses corresponding to 1/5 of the total doses were used, 100% of the patients presented satisfactory conditions (Grades 0 and 1) for traqueal intubation; to most of them muscular relaxation grade 0 was given. Only in Group I, subgroups A and "control" we observed that there was statistical significant increase in heart rate. All subgroups presented non significant alterations of arterial pressure. Fractional doses of the two agents shortened the time of beginning of the neuromuscular, blockage at traqueal intubation and satisfactory conditions of muscular traqueal relaxation in most of the cases

ASSUNTO(S)

bloqueadores neuromusculares relaxantes musculares

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