ABSTRACT

This prospective, randomized, double-blinded study aimed to compare the effects of three different doses of ketamine or lidocaine on intubating conditions and haemodynamics in a rapid-sequence induction model with 3 mg kg−1 propofol and 0.6 mg kg−1 rocuronium.

A total of 128 ASA I–III patients who were scheduled for elective surgery were randomized in the following five groups: Group 1 (n=24), 1 mg kg−1 lidocaine+3 mg kg−1 propofol+0.6 mg kg−1 rocuronium; Group 2 (n=23), 0.1 mg kg−1 ketamine+3 mg kg−1 propofol+0.6 mg kg−1 rocuronium; Group 3 (n=29), 0.3 mg kg−1 ketamine+3 mg kg−1 propofol+0.6 mg kg−1 rocuronium; Group 4 (n=26), 0.5 mg kg−1 ketamine+3 mg kg−1 propofol+0.6 mg kg−1 rocuronium and Group 5 (n=26), 3 mg kg−1 propofol+0.6 mg kg−1 rocuronium+saline as placebo. After preoxygenation, induction was performed with the assigned combination, and intubation was initiated after 60 s. The time to intubation, intubation score (Viby–Mogensen score) and haemodynamic data were recorded. Postoperative hoarseness, sore throat and hallucination incidences were followed up.

Demographic, time to intubation and haemodynamic data were comparable among groups. Group 4 [13.5 (4–14)] revealed a higher intubation score then groups 1, 2 and 5 [12 (3–14), 11 (2–14) and 9.5 (0–13) and p=0.026, p=0.001 and p=0.000001, respectively]. Groups 3 [13 (4–14)] and 4 [13.5 (4– 14)] had similar intubation scores. Side effects were comparable among all groups.

The combination of 0.5 mg kg−1 ketamine and 0.6 mg kg−1 rocuronium along with propofol improves intubation conditions in a stimulated rapid-sequence induction model.

Keywords: Intubation, rapid-sequence induction, ketamine