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Vol. 24. Núm. 6.
Páginas 253-256 (Agosto 2000)
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Vol. 24. Núm. 6.
Páginas 253-256 (Agosto 2000)
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Uso de rocuronio en la secuencia rápida de inducción-intubación de los pacientes críticos
Use of Rocuronium in the Rapid Sequence of Induction-Intubation Among Critically Ill Patients
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9739
C. Chamorro1, J.L. Martínez-Melgar, M.A. Romera, R. Ruiz de Luna, N. De La Calle, J.M. Borrallo
Servicio de Medicina Intensiva. Clínica Puerta de Hierro. Madrid.
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Objetivos

Evaluar la eficacia y seguridad del rocuronio, el bloqueador neuromuscular no despolarizante comercializado de mayor rapidez de acción, en la secuencia rápida de inducción-intubación de pacientes críticos.

Métodos

Estudio prospectivo sobre pacientes críticos ingresados en la Unidad de Cuidados Intensivos con indicación de intubación urgente. Tras la inducción anestésica y la administración de 50 mg de rocuronio, se valoró a los 60 segundos las condiciones de intubación orotraqueal mediante la escala de Krieg. Se analizaron las alteraciones hemodinámicas producidas por la administración del rocuronio.

Resultados

Se estudiaron 26 pacientes, con necesidad de intubación urgente por insuficiencia respiratoria aguda (13), disminución del nivel de conciencia (12) y shock hemorrágico (1). A los 60 segundos de la administración del rocuronio las condiciones de intubación fueron consideradas excelentes en 22 casos, buenas en 3, y no posible en 1 caso. No hubo cambios hemodinámicos significativos salvo el ascenso de la frecuencia cardíaca en el primer minuto de 103 (18) lpm a 113 (14) (p < 0,05).

Conclusiones

El rocuronio es un fármaco eficaz y seguro para la intubación urgente de los pacientes críticos.

Palabras Clave:
rocuronio
succinil-colina
intubación traqueal
paciente crítico
bloqueo neuromuscular
Objectives

To evaluate the efficacy and safety of rocuronium, the fastest nondepolarizing commercially available neuromuscular blocking agent for the rapid sequence of induction-intubation among critically ill patients.

Methods

Prospective trial on critical patients admitted to the Intensive Care Unit necessitating emergency intubation. After induction of anaesthesia and the administration of 50 mg rocuronium the orotracheal intubation conditions were evaluated at 60 seconds by means of the Krieg scale. The hemodynamic changes originated by the administration of rocuronium were analyzed.

Results

Twenty-six patients requiring emergency intubation because of acute respiratory failure (13), decrease in the consciousness level (12) and hemorrhagic shock (1) were studied. At 60 seconds after the administration of rocuronium, the intubation conditions were considered excellent in 22 cases, good in 3, and not possible in 1 case. There were no significant hemodynamic changes with the exception of an increase in the heart rate in the first minute of 103 bpm to 113 (14) (p < 0.05).

Conclusions

Rocuronium is an efficacious and safe drug for the emergency intubation of critically ill patients.

Key Words:
Rocuronium
succinylcholine
tracheal intubation
critically ill patient
neuromuscular blockade
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Copyright © 2000. Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.
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