BACKGROUND: The ease and rapidity of endotracheal incubation depends highly on the degree of muscle relaxation. The tracheal intubating conditions following equipotent doses of rocuronium, succinylcholine and vecuronium under general anesthesia with halothane, oxygen and nitrous oxide were studied and evaluated in ninety patients undergoing surgery. METHODOLOGY: Ninety patients, ASA 1-2, were randomly allocated to three groups. Group A was designated to receive 0.6 mg/kg rocuronium intravenously (n=30), group B was designated to receive 1.0 mg/kg succinylcholine intravenously (n=30) and group C was designated to receive 0.1 mg/kg vecuronium intravenously (n=30). All patients were premedicated with nalbuphine and promethazine and received 5 mg/kg thiopental for induction of anesthesia. Sixty seconds after receiving a muscle relaxant, intubation of the trachea was attempted and intubating conditions were graded by the blinded observer. Constant neuromuscular function monitoring was made using a peripheral nerve stimulator. RESULTS: Intubating conditions, sixty seconds after administration of rocuronium were clinically acceptable and comparable with those observed after succinylcholine. Rocuronium produced good to excellent intubating conditions even in the presence of incomplete block of the adductor pollicis muscle. The lag and onset time of action are significantly faster than those of vecuronium. The duration of clinical relaxation with rocuronium is however similar to that of vecuronium. CONCLUSION: Rocuronium is a new intermediate acting non depolarizing muscle relaxant with a brief lag and onset time of action that offers good to excellent interesting conditions at 60 seconds comparable with that of succinylcholine. (Author)
Human ; Middle Aged ; Adult ; Young Adult ; Adolescent ; INTUBATION ; INTUBATION, INTRATRACHEAL ; HEART RATE ; BLOOD PRESSURE ; SUCCINYLCHOLINE ; VECURONIUM BROMIDE ; MUSCLE RELAXANTS, CENTRAL ; ROCURONIUM

OBJECTIVES: To  report  a  case  of  congenital  oval  window  aplasia  (COWA)  in  a  Filipino  adult presenting   with      unilateral   maximal   conductive   hearing   loss   and   discuss   the   diagnostic considerations, pathophysiology and management.
METHODS:
Design: Case Report
Setting: Tertiary Public Referral Center
Patient: One
RESULTS: Audiometric evaluation showed a maximal unilateral left conductive hearing loss. High resolution temporal bone CT showed absence of the oval window on the left along with facial and stapes  abnormalities.    Exploratory  tympanotomy  showed  an  aberrant  facial  nerve,  monopodal and  abnormally  located  stapes  and  absent  oval  window. Postoperative  hearing  gain  achieved after a neo-oval window and Schuknecht piston wire prosthesis remained stable over two years.
CONCLUSION: A congenital minor ear anomaly classified as Cremers Class 4a in which a congenital oval  window  aplasia  was  associated  with  an  aberrant  facial  nerve  anomaly  and  a  monopodal stapes is reported. Recent literature supported the view that congenital oval window aplasia can in selected cases be amenable to various surgical approaches and a stable postoperative hearing gain is achievable in the long term.

Human ; Male ; Female ; Adult ; Ear, Middle ; Hearing