Rapid Sequence Induction Using Vecuronium

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Abstract
The purpose of this study was to determine the ideal priming and total dose of vecuronium when used as the relaxant during rapid sequence induction of anesthesia and tracheal intubation. Seventy patients were studied. Various priming and total dose schedules using vecuronium were compared with succinylcholine, 1.5 mg/kg. The mean onset times, intubating conditions, and mean duration times were compared. A priming dose of 10 μg/kg produced good intubation conditions with both 70 μg/kg and 150 μg/kg (total doses), but the mean onset times remained significantly longer than succinylcholine 1.5 mg/kg (P < 0.05). A priming dose of 15 μg/kg of vecuronium with 100 μg/kg total dose, on the other hand, not only produced excellent intubating conditions but also resulted in a mean onset time not significantly different from succinylcholine, 1.5 mg/kg. This latter dose schedule of vecuronium is recommended for rapid sequence induction when succinylcholine is contraindicated. Vecuronium is preferable to pancuronium for rapid sequence induction because of its lack of cardiovascular side effects and short duration.

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