Abstract No. : ABS0423: Comparison of two different doses of Atracurium for muscle relaxation quality in rapid sequence induction in emergency laparotomies : A randomised prospective study

Abstract

Background & Aims: In emergency and non-fasting patients, rapid sequenceinduction (RSI) is preferred, which is routinely done by rocuronium or succinylcholine. To avoid adverse effects of these drugs, atracurium in high dose i.e.3-4times ED95 can be used to provide good intubating conditions. The present study therefore aimed to study and compare two doses of atracurium (0.75mg/kg and 1mg/kg) with regards to quality of muscle relaxation RSI Methods: After obtaining institutional ethical committee clearance and written informed consent from sixty patients, they wererandomly assigned into two groups and were given premedication and induced with inj. propofol 2mg/kg and two different doses of Atracurium 0.75mg/kg in group A and 1mg/kg in group B without a priming dose. Intubation was performed bytrained anesthesiologists within a minute. At the same time, all intubating conditions, neuromuscular monitoring i.e Train of four measurement, and haemodynamics were measured. Data was analysed statistically by using the SPSS version20. Results: Atracurium doses of 0.75mg/kg and 1mg/kg achieved a 13.3% and 56.7% success rate of intubation without coughing orbucking. Atracurium higher dose had a longer duration of action than low dose. The duration measured by time until TOF was two (in min) was 60.13±8.7 & 79.2±9.2 (p<0.001) on giving of 0.75mg/kg and 1mg/kg atracurium respectively. Conclusion: Administration of high dose (1mg/kg) atracurium helps in achieving good intubating conditions during RSI. Hence atracurium can be used as a better alternative drug to succinylcholine for RSI..