Double-blind comparison of two doses of rocuronium and succinylcholine for rapid-sequence intubation.
OBJECTIVE
To compare the pharmacodynamics of two commonly recommended doses of rocuronium bromide (0.7 mg/kg and 0.9 mg/kg) and succinylcholine (1.5 mg/kg) when used for rapid-sequence intubation.


METHODS
Prospective, double-blind, randomized study.


METHODS
Operating rooms at a university hospital.


METHODS
45 ASA physical status I and II adult patients scheduled for elective surgeries under general anesthesia.


METHODS
Nonpremedicated patients were anesthetized with fentanyl 2 mcg/kg followed by thiopental sodium 4 to 5 mg/kg and muscle relaxant using rapid-sequence technique. Group 1 (n = 15) received rocuronium bromide 0.7 mg/kg. Group 2 (n = 16) received rocuronium bromide 0.9 mg/kg, and Group 3 (n = 14) received succinylcholine 1.5 mg/kg. Intubation was performed 60 seconds after the administration of muscle relaxant.


RESULTS
The case of intubation was scored using a scale of 1 to 4. Blood pressure and heart rate were measured beginning one minute before induction of anesthesia up to 5 minutes after intubation. Intubation scores were similar in groups 2 and 3 and were noted as good or excellent in all patients. Group 1 displayed a significantly lower intubation score than the other two groups; 60% were rated as poor. No significant differences in hemodynamic data were seen among the three groups.


CONCLUSIONS
Rocuronium bromide at a dose of 0.9 mg/kg provides intubating conditions similar to succinylcholine 1.5 mg/kg at 1 minute. Intubating conditions at 1 minute following a 0.7 mg/kg dose of rocuronium are not as good as those following a 0.9 mg/kg dose of rocuronium or a 1.5 mg/kg dose of succinylcholine.
Weiss
J H
JH
Department of Anesthesiology, Cooper Hospital/University Medical Center, Camden, NJ 08103, USA.
Gratz
I
I
Goldberg
M E
ME
Afshar
M
M
Insinga
F
F
Larijani
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000732:Androstanols / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D006801:Humans; D007442:Intubation, Intratracheal; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000494:pharmacology*; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D011446:Prospective Studies; D000077123:Rocuronium; D013390:Succinylcholine / Q000494:pharmacology*; D013997:Time Factors
D000732:Androstanols; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D013390:Succinylcholine; D000077123:Rocuronium