Conference

8th and 9th November 2014
3rd and 4th November
March 4th 2012, Sunday

RAPID SEQUENCE INDUCTION-THIO

3 replies [Last post]
jibin sam mathew
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Joined: 25 Feb 2010

HI

is there any specific rate at which thiopentone be given in rsi or is it  best given as a bolus ?

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Sameer Jahagirdar
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Joined: 30 Dec 2009
dear dr. Jibin

dear dr. Jibin Sam,

                 There is no precise rate of administration of Thipoentone like 1 ml/min or 5 mg/ min!. When we talk about Rapid sequence induction, our aim is to administer the predecided, calculated dose of Thiopentone. By this it means the dose of drug which will be sufficient enough to make patient sleep without causing much hemodynamic embarassment, specially in hypovolaemic patients.The precise (predetermined, calculated) 'sleep' dose of thiopentone administered to cause rapid loss of consciousness and hasten subsequent adminisration of (rapid acting) neuromuscular blocking drug to secure airway as fast as possible. There was a method called Crash induction used in 70s( http://journals.lww.com/surveyanesthesiology/Citation/1969/04000/Hazards...)
where thiopentone in large doses was administered which made patients to Crash hemodynamically.

               So its dose administered  rapidly to make patient sleep fast rather than rate of administration that matters in RSI. Dear members, kindly share ur views on this.

       

r sripriya
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Joined: 14 Feb 2010
the predetermined ,

the predetermined , precalculated drug has to be administered in one arm brain circulation time.and if the patient is not under we give a supplemental dose.so the rate is probably the precalculated dose divided by one arm brain circulation time.......is it not.our experts have to enlighten us on this.

Satyen Parida
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Joined: 24 Jan 2010
Not aware of any specific

Not aware of any specific rate at which the drug be administered. I guess the idea is principally to give a pre-calculated dose of the induction agent. Ensuring adequate hypnosis is paramount and hence the idea of the "sleep" dose is abandoned. Rate of administration could be the same as for regular induction, without however checking whether the patient is purportedly "under" or not...