Evaluation of a rapid sequence induction technique in dogs with or without rocuronium

H Nicole Trenholme; Daniel M Sakai; Hannah A Craig; Frederick J Torpy; Rachel A Reed; Manuel Martin-Flores

doi:10.1016/j.vaa.2023.11.004

Evaluation of a rapid sequence induction technique in dogs with or without rocuronium

Vet Anaesth Analg. 2024 Jan;51(1):52-59. doi: 10.1016/j.vaa.2023.11.004. Epub 2023 Nov 16.

Authors

H Nicole Trenholme¹, Daniel M Sakai², Hannah A Craig³, Frederick J Torpy³, Rachel A Reed¹, Manuel Martin-Flores⁴

Affiliations

¹ Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
² Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA. Electronic address: dmsakai@uga.edu.
³ Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
⁴ Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.

PMID: 38071121
DOI: 10.1016/j.vaa.2023.11.004

Abstract

Objective: To determine, using a rapid sequence induction (RSI) technique, whether rocuronium improves the quality and speed of endotracheal intubation in healthy dogs.

Study design: Randomized, crossover, experimental study.

Animals: Six adult intact male Beagles (12.3 ± 0.4 kg).

Methods: Dogs were premedicated with intravenous acepromazine (0.03 mg kg^-1) and hydromorphone (0.1 mg kg^-1). Ten minutes later, anesthesia was induced with intravenous propofol (2 mg kg^-1 over 5 seconds), followed by saline (0.06 mL kg^-1, CT group) or rocuronium (0.6 mg kg^-1, RT group), with orotracheal intubation attempted after 45 seconds. Intubation time (IT) and conditions (IC) were assessed. PaO₂, PaCO₂, arterial blood pH and serum cortisol were obtained before and after RSI. After endotracheal intubation, saline (0.04 mL kg^-1) or sugammadex (4 mg kg^-1) were administered intravenously in CT or RT groups, respectively. Spontaneous ventilation restoration was noted.

Results: The IT was 54.3 ± 6.9 (mean ± SD) and 57.8 ± 5.2 seconds for CT and RT, respectively (p = 0.385). All laryngoscopies indicated good IC in both treatment groups. Heart rate was lower in CT group than in RT group (66 ± 16 versus 103 ± 39 beats minute^-1, p = 0.016). PaCO₂, pH, PaO₂ and cortisol did not differ between treatments. Compared with baseline, PaCO₂ increased from 47.7 ± 6.2 to 58.8 ± 5.8 (p < 0.001) and pH decreased from 7.35 ± 0.04 to 7.28 ± 0.04 (p = 0.003), independent of treatment. Dogs in both treatment groups returned to spontaneous ventilation within 30 seconds of RSI.

Conclusions and clinical relevance: RSI resulted in respiratory acidosis without hypoxemia or increased cortisol. Rocuronium did not improve IT or IC. Spontaneous ventilation was observed immediately after administering saline or sugammadex. The co-administration of rocuronium showed no clinical benefits over propofol alone in RSI in healthy dogs.

Keywords: aspiration pneumonia; blood glucose; hypoxemia; neuromuscular blocking agent; stress.

Publication types

Randomized Controlled Trial, Veterinary

MeSH terms

Androstanols / pharmacology
Anesthetics, Intravenous
Animals
Dogs
Hydrocortisone
Intubation, Intratracheal / veterinary
Male
Propofol*
Rapid Sequence Induction and Intubation / veterinary
Rocuronium
Sugammadex

Substances

Androstanols
Anesthetics, Intravenous
Hydrocortisone
Propofol
Rocuronium
Sugammadex