Intubating Conditions of two Different Doses of Rocuronium At 60 Seconds; by Clinical Assessment; and with T.O.F Response of Adductor Pollicis Muscle.
BACKGROUND
At 60 seconds, 2xED95 dose (0.6mg/kg) of rocuronium is frequently used for intubation. Some studies suggest 3XED95 (0.9mg/kg body weight) dose in achieving excellent intubating conditions. In this context, present study aimed at comparing intubating conditions with these two doses of rocuronium, using clinical criteria by cooper's score; assisted with adductor pollicis T.O.F response.


METHODS
Present prospective randomized comparative clinical study was conducted on 60 patients subjected for general anaesthesia. Induction was done with fentanyl (1mcg/kg body weight) and propofol (2mg/kg body weight) and relaxation achieved with Rocuronium 0.6 mg/kg (Group A-30 cases); 0.9mg/kg (Group B- 30 cases). (n=30) intubation was done at 60 seconds. Intubating conditions were assessed clinically by cooper's score.T.O.F responses of AP by visual and tactile means.


RESULTS
Intubating conditions clinically were excellent in 16 cases (53%), good in 12 cases (40%), and fair in 2 cases (7%) respectively in Group-A. In group-B excellent in 29 cases (97%) and good in 1case (3%). In group A in no case TOF-0 achieved. TOF 1, 2, 3, and 4 were observed in 1 case (3%), 7 cases (23%) 16 cases (54%) and 6 cases (20%) respectively. Whereas in group B, TOF 0, 1, 2, 3 were observed in 18 cases (61%), 4 cases (13%), 7 cases (23%) and 1 case (3%). In no case TOF-4 observed. Chi square test (p<0.0001) confirmed a highly significant statistical difference with respect to elicited TOFcounts, and intubating conditions achieved.


CONCLUSIONS
3xED95 dose of Rocuronium achieves more intense NMB and better conditions for intubation at 60 seconds than 2ED 95 dose.
Assistant Professor, Department of Cardiac Anaesthesia, Shri Jayadeva Institute of Cardio Vascular Sciences and Research , Banneraghatta Road-Bangalore, Karnataka, India .
Vijayakumar M
VM
Heggeri
Faculty, Department of General Medicine, IMO-Grade IIESIC Hospital-Peenya , Bangalore, India .
Aparna S
AS
Harbishettar
Professor & Former HOD, Department of Anaesthesiology and Critical Care Gauhati Medical College; Chief Consultant, Department of Anaesthesiology and Intensive Care, Nam Care Hospital , Bhanghaghar, Gauhati, Assam, India .
Ajitkumar
A
Deka
Associate Professor, Department of Anaesthesiology and Critical Care, Gauhati Medical College -Guwahati-Assam, India .
Tejwant
T
Rajkhowa
ED95; Fade; Neuromuscular blockade; Non depolarizing muscle relaxant; Supra maximal stimulus; Train of four response; Visual/tactile means