Rocuronium versus succinylcholine-atracurium for tracheal intubation and maintenance relaxation during propofol anesthesia.
OBJECTIVE
To compare the onset and offset time (clinical duration), and intubating conditions obtained with rocuronium bromide 0.6 mg/kg and succinylcholine 1.0 mg/kg after induction with propofol and fentanyl; and to compare rocuronium with atracurium for maintenance during propofol anesthesia.


METHODS
Prospective, open-label, parallel group comparative, randomized study.


METHODS
Operating rooms of a university hospital.


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


METHODS
Patients premedicated with midazolam 2 mg were anesthetized with fentanyl 2 microg/kg followed by propofol 2.5 mg/kg and muscle relaxants. Group 1 (n = 15) received succinylcholine 1.5 mg/kg and Group 2 (n = 16) received rocuronium bromide 0.6 mg/kg. Intubation was performed 60 seconds after the administration of muscle relaxant. Patients in Group 1 received atracurium and patients in Group 2 received rocuronium for maintenance if required.


METHODS
The ease of intubation was scored using a scale of 1 to 4. Onset and offset time monitored with evoked twitch response of the adductor pollicis were recorded.


RESULTS
Intubation was successful in all patients and there was no difference in scores between the two groups. Although onset time was shorter with succinylcholine than with rocuronium, neuromuscular blockade was successfully antagonized in both groups, and the recovery profile was not different between the two groups.


CONCLUSIONS
Rocuronium bromide at a dose of 0.6 mg/kg, when used with propofol and fentanyl for induction, provides intubating conditions similar to succinylcholine 1.0 mg/kg at 1 minute. The actual onset time and offset time, however, are significantly longer with rocuronium. There was no difference between atracurium and rocuronium as a maintenance drug. Rocuronium is suitable for surgical procedures greater than 30 minutes, eliminating the need for an additional relaxant to succinylcholine.
Lam
A M
AM
Department of Anesthesiology, Harborview Medical Center, University of Washington, Seattle, WA 98104, USA.
Pavlin
E G
EG
Visco
E
E
Taraday
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000732:Androstanols / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001279:Atracurium / Q000008:administration & dosage / Q000494:pharmacology*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D000077123:Rocuronium; D013390:Succinylcholine / Q000008:administration & dosage / Q000494:pharmacology*; D013997:Time Factors
D000732:Androstanols; D018686:Anesthetics, Intravenous; D004338:Drug Combinations; D009466:Neuromuscular Blocking Agents; D001279:Atracurium; D013390:Succinylcholine; D000077123:Rocuronium; D015742:Propofol