Evaluation Of Atracurium Besylate and Vecuronium Bromide in Combination to Facilitate Rapid Tracheal Intubation

Background: Combination of atracurium and vecuronium is a good alternative for rapid tracheal intubation in certain conditions where one has to avoid giving succinylcholine as a muscle relaxant. It has been shown good synergism between two drugs for mechanism of action, duration of action, haemodynamic stability, and recovery from anaesthesia. Materials and Methods: A total of 75 patients were studied in 3 groups having 25 patients in each. Intubating conditions were studied after 75 seconds and 90 seconds in combination of atracurium and vecuronium with same dose. Pulse rate and systolic blood pressures were monitored during intubation and subsequently during maintenance. Results: Combination of atracurium and vecuronium gave clinically acceptable intubating condition in majority of patients in 75 seconds but in 90 seconds, it gave similar results to that of suxamethonium at the cost of longer duration. Alone vecuronium is not a suitable non depolarizing muscle relaxant for rapid sequence induction. No significant difference in haemodynamic data were noted in all three groups. Good and early recovery was noted in combination of atracurium and vecuronium. Combination of two drugs was synergistic and more potent in an equipotent dose ratio favouring one parent drug so maximum reduction of drug requirement would be about 40%

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes