New Induction Technique Obtained with Combined Administration of Midazolam and Vecuronium, Followed by Low Dose Thiobarbiturate

Rapid anesthesia induction obtained with combined administration of midazolam and vecuronium followed by a low dose of thiamylal was studied in 300 patients. The patients were divided into three groups (100 patients, each). Group 1 received midazolam 3mg and vecuronium 3mg, group 2 received midazolam 4mg and vecuronium 4mg, and group 3 received midazolam 5 mg and vecuronium 5mg. All patients were administered thiamylal 125mg. Bucking reaction at the time of endotracheal intubation occurred in 39% of group 1, 34% of group 2 and 15% of group 3. Flumazenil was required for reversal of midazolaminduced postoperative hypnosis in 9% in group 1, 11% in group 2 and 16% in group 3. Blood pressure and pulse rate were significantly changed during induction of anesthesia, although the changes were within 20mmHg and 20bpm, respectively. From these findings, combined administration of midazolam and vecuronium (especially midazolam 4mg and vecuronium 4mg) and subsequent administration of a low dose of thiobarbiturate is suggested to be a reliable technique for rapid and safe induction, regardless of the patient's body weight and age.