Routine Induction of Anaesthesia with Thiopental and Suxamethonium: Apnoea without Ventilation?

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Abstract
Changes in PaO2 and PaCO2 during the induction of anaesthesia with thiopental, suxamethonium, and intubation were investigated in 20 patients who received preoxygenation for 2 min, but no ventilation before intubation. Both in fit patients below the age of 60 years (Group I) and in patients above that age ‐ several suffering from cardiopulmonary disease ‐ (Group II), PaO2 increased to about 40 kPa during preoxygenation and remained at that level during apnoea. Mean PaCO2 increased to 6.3 and 5.7 kPa in Groups I and II, respectively. No complications were seen, and it is concluded that the apnoea involved in the “crash induction” technique is safe. Pulmonary aspiration of acid gastric fluid may also occur in fasting patients, and it is suggrhted that even in elective cases ventilation might advantageously be replaced by preoxygenation when anaesthesia is induced with thiopental and suxamethonium.