Comparison of the effect of intravenous administration of atracurium by preparation method with intravenous injection of atracurium with presleep method with intravenous administration of rocuronium at the optimal time of intubation in induction of anesthesia by rapid sequence method using muscle nerve relaxation monitoring

Comparison of the effect of intravenous administration of atracurium by preparation method with presleep method with intravenous administration of rocuronium at the optimal time of intubation

Clinical trial, parallel groups, double-blind, randomized, phase 3 on 90 patients. In order to randomize, the block randomization method will be used.

Patients who are candidates for general anesthesia at Firouzgar and Rasoul Akram Hospitals in Tehran will be included in the study. Patients will be randomly divided into 3 groups based on blocks of 3. Patients and data analyst will be blinded.

Inclusion criteria: Non-emergency surgery, under general anesthesia for more than 120 minutes, Age between 18-50 years, Malampathi 1 and 2, A person with normal health, A person with mild systemic disease. Non-entry criteria: Allergy to the drugs used in the plan, History of asthma, Anxiety, Hemodynamic instability, Addiction, Heart disease, Lung disease, Active cancer, Taking drugs that increase muscle relaxation

Intervention group 1: In the Prehypnotic group, intravenous midazolam and intravenous fentanyl will be prescribed as a Premedication. The patient will be per oxygenated from the beginning and after 3 minutes, atracurium and 20 seconds after that, Sodium thiopental will be administered intravenously. Intervention group 2: In the Priming group, atracurium will be injected with two Premedication drugs to the patient at the same time. 3 minutes later, sodium thiopental will be administered intravenously, followed by atracurium will be prescribed to the patient in full. Control group: after midazolam and fentanyl, sodium thiopental and immediately rocuronium will be injected intravenously.

The time required from the moment of drug injection until the muscles relax

Patients will be randomly divided into 3 groups. The randomization tool will randomize the table of numbers; The list of random numbers will be received by the researcher from the statistician and the patients included in the study will be divided into three groups. Block randomization method will be used for randomization. Block randomization is for the purpose of making sure that exactly equal number of participants enter the study groups. The advantages of block randomization are that the balance of the number of participants in each group is guaranteed. For this purpose, 9 blocks will be formed and in each block 3 people from intervention group 1, 3 people from intervention group 2 and 3 people will be placed in the control group. A total of 10 blocks will be considered to reach the sample size. Blocks contain numbers, numbers represent study groups. Their order will be determined by the statistician from the beginning. In order to hide the random allocation, opaque envelopes sealed with a random sequence will be used. In this method, each of the generated random sequences will be recorded on a card and the cards will be placed in the envelopes in order. became. In order to maintain a random sequence, the outer surface of the envelopes is numbered in the same order. Finally, the lid of the letter envelopes is glued and placed in a box. At the time of registration of participants, based on the order of entry of qualified participants into the study, one of the envelopes will be opened in order and the assigned group of that participant will be revealed.

Patients will be unaware and blind about the type of drug injected. Patients will be aware that they will be randomly assigned to one of the three study groups, but will not know which method will be offered in that group. Patients will be assigned to one of three groups using a random number table. The anesthetist who injects the drug will know the patient category. The person in charge of data collection, the analyst, and the outcome evaluator will collect and analyze the information based on groups 1, 2 and 3, and will not know the type of drug injected in the groups and will be kept blind.