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Volume 12 Issue 2 ( April- June) 2023

Original Articles

Comparison of different doses of atracurium for quality of muscle relaxation during modified rapid sequence induction in emergency laparotomy
Dr. Guneet Sodhi

Background and Aims: Rapid sequence induction (RSI) using succinylcholine or rocuronium is the method of choice when a laparotomy under general anesthesia is to be performed on an emergency or nonfasting patient. It is possible to achieve satisfactory intubating circumstances rapidly with increased dosages of atracurium. The primary focus of our investigation was comparing two higher doses of atracurium to achieve desirable intubating conditions for RSI without the need for a priming dose. The secondary objective was to assess if there was a connection between the length of time it took for patients' muscles to relax following intubation and their hemodynamic responses.Methods:Fifty patients were enrolled, with half assigned to Group A1 (atracurium dose of 0.75 mg/kg) and the other half to Group A2 (atracurium dose of 1 mg/kg). Within one minute, the patient was premedicated, induced with propofol 2 2.5 mg/kg and atracurium injections, and intubated. After documenting the intubation scenario and neuromuscular monitoring using train of four (TOF) data, a post-tetanic count and hemodynamics were acquired. Statistical analysis was performed using the Chi-square test and the Student's t test.Results:When comparing groups A1 (55.23 9.0 min) and A2 (74.3 8.9 min), group A2 had significantly longer muscular relaxation times (P 0.001). In conclusion, a high dosage of atracurium (1 mg/ kg) may be used during RSI to establish acceptable intubating circumstances in under a minute. Therefore, atracurium may serve as a replacement medication for RSI.

 
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