A comparative, randomized clinical study of haemodynamic response to laryngoscopy and tracheal intubation using vecuronium with and without neuromuscular monitoring by peripheral nerve stimulator

Introduction: Laryngoscopy and endotracheal intubation during induction of general anaesthesia are extremely strong nociceptive stimuli, which often lead to unintended stimulating of the sympathetic nervous system manifested by increased arterial pressure and tachycardia.1 The present study aimed to assess usefulness of neuromuscular monitoring with peripheral nerve stimulator in reducing the haemodynamic response to laryngoscopy and tracheal intubation using vecuronium. Material and Methods: This study included 100 cases classified randomly into two group (Each n= 50). Group I (C) (n=50): control group: Laryngoscopy and tracheal intubation done at the end of 3 minutes after administration of 0.1mg/kg body weight of intravenous iv vecuronium. Group II (N) n=50: Neuromuscular monitoring done after giving 0.1mg/kg body weight of intravenous vecuronium using TOF with supramaximal stimuli of current intensity 50 mA at right ulnar nerve, and the response of the thumb is monitored every 10 seconds, once all the responses for TOF are lost, the time noted and laryngoscopy and endotracheal intubation were performed. Statistical Analysis: Independent- Samples t test, Cross tabs and Repeated Measure ANOVA were used. SPSS for windows (version 17.0) was employed for data analysis. p<0> Results: Group-N (study group) showed statistically significant decreased haemodynamic response to laryngoscopy and intubation after iv Vecuronium, when compared to Group-C (control group). Conclusion: Neuromuscular monitoring by using PNS at AP is useful to have good intubation condition and to reduce the haemodynamic response to laryngoscopy and intubation.