Pharmacodynamics of rocuronium with and without prior administration of succinylcholine.
OBJECTIVE
To compare succinylcholine (S) and rocuronium (R) used for endotracheal intubation, and to assess the possible action of S on subsequently administered R.


METHODS
Double-blind, randomized, phase III study.


METHODS
University Medical Center.


METHODS
24 ASA physical status I and II patients, ages 28 to 65, undergoing general anesthesia for abdominal procedures.


METHODS
Double-blind administration of R 600 mcg/kg (Group A) or S 1 mg/kg was achieved with open label R 150 mcg/kg. Standardized general anesthetic technique with sodium thiopental, fentanyl, and nitrous oxide in oxygen was administered.


RESULTS
Neuromuscular junction was tested by ulnar nerve stimulation and mechanomyograph. Intubation was attempted at 80% first twitch depression of train-of-four. Heart rate and blood pressure were recorded throughout. Onset times were 74 +/- 37 seconds for S and 130 +/- 46 seconds for R. Intubation times were 76 +/- 29 seconds for S and 85 +/- 23 seconds for R (no significant difference). Good to excellent intubation conditions were achieved in both groups. S given prior to R decreased onset time and increased duration of R, when compared with R given alone. No drug related cardiovascular events were noted.


CONCLUSIONS
Rapid intubation conditions can be obtained after both S and R. Given its overall safety profile, R can be used when S is contraindicated, or in healthy patients with no apparent difficult airway, when procedures are expected to last more than 25 minutes.
Dubois
M Y
MY
Department of Anesthesia, Georgetown University Medical Center, Washington, D.C., USA.
Lea
D E
DE
Kataria
B
B
Gadde
P L
PL
Tran
D Q
DQ
Shearrow
T
T
D000328:Adult; D000368:Aged; D000732:Androstanols / Q000494:pharmacology*; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009469:Neuromuscular Junction / Q000187:drug effects; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D000077123:Rocuronium; D013390:Succinylcholine / Q000494:pharmacology*; D013997:Time Factors; D014459:Ulnar Nerve / Q000187:drug effects
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D013390:Succinylcholine; D000077123:Rocuronium