Intubating conditions and twitch height of adductor pollicis brevis muscle at 90 seconds after rocuronium 0.6 mg/kg in simulated rapid sequence induction: comparison between young adult and elderly

Abstract Background: The present study was designed to compare the incidence of postoperative sore throat, hoarseness, and myalgia between rocuronium and succinylcholine for rapid sequence induction and intubation. Methods: One hundred and twenty-four patients were randomly divided into rocuroniun group (group R, n=62) or succinylcholine group (group S, n=62). Anesthesia was induced with propofol 2mg kg-1 and remifentanil 2μg kg-1in both groups, and then rocuronium 0.6 mg kg-1 or succinylcholine 1.5mg kg-1 was given after patient lost consciousness. Tracheal intubation was performed 60s after these two muscle relaxants were given and the intubating conditions were evaluated. The incidences of postoperative sore throat, hoarseness and myalgia were evaluated at postoperative care unit(PACU), 12hours 24hours and 48hours postoperatively. Results: The numbers of patients with excellent and good intubating conditions in group R were 90.0% and 6.7%, respectively, which were comparable with those in group S (91.7% and 5.0% respectively). The incidence of postoperative sore throat of group S (41.8%) was significantly higher than that of group R (18.3%) in PACU (P<0.05), at 12 hours (38% versus 10%, P<0.05) and 24 hours postoperatively (32% versus 6.7%, P<0.05), however, these differences reached an insignificant level at 48 hours postoperatively (3.3% versus 1.7%). There were some cases in both groups underwent hoarseness and/or myalgia at each time point, but the differences did not reach a significant level. Conclusions: In the context of a RSII with lidocaine–remifentanil–propofol, compared with rocuronium, succinylcholine supplementation was associated with high incidence of postoperative sore throat. Trial registration: The present study was prospectively registered at http://www.chictr. org/cn/(ChiCTR-IOR-15006977); Registration date: Nov 4, 2015 Keywords: Rocuronium, Succinylcholine, Sore Throat, Hoarseness, Myalgia

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Comparison of Intubating Conditions After Rapacuronium (Org 9487) and Succinylcholine Following Rapid Sequence Induction in Adult Patients

Survey of Anesthesiology ◽

10.1097/00132586-199912000-00018 ◽

1999 ◽

Vol 43 (6) ◽

pp. 321

Author(s):

H. J. SPARR ◽

H. MELLINGHOFF ◽

M. BLOBNER ◽

G. NÖLDGE-SCHOMBURG

Keyword(s):

Rapid Sequence Induction ◽

Adult Patients ◽

Intubating Conditions ◽

Org 9487 ◽

Rapid Sequence ◽

Sequence Induction

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Intubating conditions following rapid sequence induction with three doses of succinylcholine

Indian Journal of Anaesthesia ◽

10.4103/0019-5049.96309 ◽

2012 ◽

Vol 56 (2) ◽

pp. 139 ◽

Cited By ~ 3

Author(s):

Smita Prakash ◽

Preeti Thakur ◽

Rajvir Singh ◽

Sushma Barde ◽

AnoopRaj Gogia

Keyword(s):

Rapid Sequence Induction ◽

Intubating Conditions ◽

Rapid Sequence ◽

Sequence Induction

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Rocuronium for intubation in parturients undergoing caesarean section

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184060 ◽

2018 ◽

Vol 6 (10) ◽

pp. 3441

Author(s):

Sajina M. ◽

Medha A. Sangawar ◽

Sangawar A. V. ◽

Niraj Bannore

Keyword(s):

Muscle Relaxant ◽

Rapid Sequence Induction ◽

Anaesthetic Management ◽

Neuromuscular Blocking ◽

Onset Of Action ◽

Promising Alternative ◽

Intubating Conditions ◽

Rapid Sequence ◽

Sequence Induction ◽

The Mean

Background: Anaesthetic management of a parturient is a challenge because it involves simultaneous care of both mother and baby. Succinylcholine, a depolarizing muscle relaxant is most commonly used and considered “The Gold Standard’’ for tracheal intubation. Among currently available non-depolarizing neuromuscular blocking agent rocuronium bromide is the only agent that has rapid onset of action which is comparable to succinylcholine. Thus, rocuronium may provide alternative to succinylcholine for rapid sequence induction of anaesthesia wherever succinylcholine is contraindicated.Methods: In a control trial, 60 parturients of ASA grade I and II were randomly allocated in two groups of 30 patients each (group R and group S). After preoxygenation for a period of 5minutes rapid sequence induction done with thiopentone 5mg/kg for all patients. Muscle relaxant rocuronium (0.6mg/kg) was administered for group R. Succinylcholine was given in similar dosage (0.6mg/kg) for group S. The intubation was tried after 90 seconds in group R (rocuronium group) but after 60 seconds in group S (succinylcholie group). The intubating conditions were assessed and compared among the groups using criteria suggested by Cooper et al.Results: The mean intubation time was 98.3 seconds in group R and 67.9 seconds in group S. Rocuronium produced clinically acceptable intubating conditions in 28 out 30 patients (93.33%). Among these 28 patients 70% had excellent intubating conditions and 23.33% had good intubating conditions. Clinically acceptable intubating conditions were present in all 30 patients (100%-90% excellent and 10% good) who were administered succinylcholine. Succinylcholine produced excellent intubating conditions at 60 seconds (90 percent) compared to rocuronium (70 percent). However, this difference was statistically insignificant (p= 0.053). The mean Apgar score at 1 min and 5 min in group R was 8.1 and 8.83 as against 8.06 and 8.96 in babies born to mother in group S.Conclusions: Rocuronium (0.6mg/kg) provided acceptable intubation conditions after a waiting period of 90 seconds in 93.33% patients as against 100% patients in succinylcholine administered patients in equivalent dosage. So rocuronium is a promising alternative for rapid sequence induction in parturients in whom succinylcholine is not advisable or contraindicated.

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