Abstract
Background: Rocuronium Bromide is an ewer, low potency non-depolarising neuromuscular blocking agent. Patients often require an endotracheal intubation technique during emergencies or electively to protect against aspiration, increased intracranial pressure, or to facilitate intubation. Traditionally succinylcholine has been the most commonly used muscle relaxant for this purpose because of its fast onset and short duration; unfortunately, it can have serious side effects. Rocuronium has been suggested as an alternative to succinylcholine for intubation The aim of this study was to compare tracheal intubating conditions, onset time, duration of action of rocuronium 0.9 mg/kg, 0.6 mg/kg and succinylcholine 1.5 mg/kg during induction of anaesthesia.
Methods and findings: This prospective, randomized, double – blind study was carried out in seventy- five ASA grade (I – II) adults, aged 18-65 years of either sex, who were scheduled to undergo various surgeries under general anaesthesia. Patients were divided into three groups. Group I received succinyl choline 1.5 mg/kg intravenously (n=25), Group II received rocuronium0.6mg/kg intravenously (n=25), Group III received rocuronium 0.9 mg/kg intravenously (n=25) after induction with propofol. Intubation was attempted on fading of all four twitches of adductor pollicis muscle, evoked after train of four stimulation of ulnar nerve using a peripheral nerve stimulator at every 15 seconds after injection of muscle relaxant. Onset time, duration of action and intubating conditions were assessed.
Results: Excellent intubating conditions were obtained in 84 %, 56 % and84 % of the patients after administration of succinyl choline 1.5 mg/kg, rocuronium 0.6 mg/kg and rocuronium 0.9 mg/kg respectively; P 0.032. Acceptable intubating conditions (excellent and good grade combined) were obtained in all patients. Onset time and duration of action were significantly more in rocuronium group 0.9 mg/kg (111.00±19.3 sec and 45.60±6.87 min respectively) as compared to rocuronium 0.6 mg/kg (195.72±34.62 sec and 27.04±6.79 min respectively) while succinyl choline group (64.92±10.91 sec and 8.64±2.23 min respectively).
Conclusion: Rocuronium has anintermediate duration of action. Onsettime of rocuronium is reduced with increase in dose from 0.6 mg/kg to 0.9 mg/kg. Rocuronium provides clinically acceptable intubating conditions comparable to that of succinyl choline.
Keywords: Anaesthesia, intubating conditions, rapid sequence induction, succinylcholine, rocuronium.
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DOI: https://dx.doi.org/10.18535/jmscr/v5i5.138
