Thiopentone and pancuronium crash induction

Abstract

A previous paper,' evaluated some potential hazards in a 'crash induction' technique using thiopentone and suxamethonium. For elective surgery, many anaesthetists use a long-acting muscle relaxant both for intubation and maintenance relaxation. Although rarely reported, similar techniques are also employed in the presence of a 'full s t o m a~h ' .~ This paper describes a technique of induction by rapid injection of pancuronium and thiopentone. A standard timing of laryngoscopy and intubation is used, based on loss of lid reflex as a guide to the circulation time.The technique was developed by the authors using premixed thiopentone and pancuronium for fit patients undergoing elective surgery and later for those at risk from a 'full stomach'. This work was not published, since the current formulation of pancuronium no longer mixes with thiopentone, but the safety and consistency of the results encouraged us to adapt the protocol to the present study. Material AnaesthetistsFive junior anaesthetists, on the basis of long experience, proven competence and willingness to use the technique were selected to assist the authors in the investigation.