Comparison of rocuronium and suxamethonium for rapid tracheal intubation in children.
BACKGROUND
The purpose of our study was to determine whether a smaller dose of rocuronium than previously reported could provide similar intubating conditions to suxamethonium during rapid-sequence induction of anaesthesia in children.


METHODS
One hundred and twenty ASA I, unpremedicated children, aged 1-10 years, who were undergoing elective surgery, were randomized into three groups to receive rocuronium 0.6 mg.kg-1, rocuronium 0.9 mg.kg-1 or suxamethonium 1.5 mg.kg-1. The study was double-blinded, anaesthesia and timing of injection was standardized to alfentanil 10 microg.kg-1, thiopentone 5 mg.kg-1 and the study drug. Intubation was attempted at 30 s after injection of neuromuscular relaxant and intubating conditions graded as excellent, good, poor or impossible.


RESULTS
All 120 children were successfully intubated within 60 s without need for a second attempt after administration of neuromuscular relaxant. Differences between suxamethonium and rocuronium 0.6 mg.kg-1 and between the two doses of rocuronium were statistically significant (P=0.016 and 0.007, respectively).


CONCLUSIONS
Rocuronium 0.9 mg.kg-1 provides similar intubating conditions to suxamethonium 1.5 mg.kg-1 during modified rapid-sequence induction using alfentanil and thiopentone in children (P=0.671). Rocuronium 0.6 mg.kg-1 was inadequate.
Cheng
Claudia A Y
CA
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, New Territories, Hong Kong.
Aun
Cindy S T
CS
Gin
Tony
T
D015760:Alfentanil; D000732:Androstanols / Q000008:administration & dosage; D000758:Anesthesia; D018686:Anesthetics, Intravenous; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage; D000077123:Rocuronium; D013390:Succinylcholine / Q000008:administration & dosage; D013874:Thiopental; D013997:Time Factors
D000732:Androstanols; D018686:Anesthetics, Intravenous; D009467:Neuromuscular Depolarizing Agents; D015760:Alfentanil; D013390:Succinylcholine; D013874:Thiopental; D000077123:Rocuronium