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A large simple randomized trial of rocuronium versus succinylcholine in rapid‐sequence induction of anaesthesia along with propofol
Author(s) -
Andrews J. I.,
Kumar N.,
Van Den Brom R. H. G.,
Olkkola K. T.,
Roest G. J.,
Wright P. M. C.
Publication year - 1999
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.1999.430102.x
Subject(s) - rocuronium , medicine , propofol , rapid sequence induction , anesthesia , rocuronium bromide , muscle relaxant , general anaesthesia , onset of action , intubation
Background: Rocuronium has an onset of action more rapid than other non‐depolarizing neuromuscular blocking agents, but it is unclear whether it and succinylcholine give equivalent intubating conditions during rapid‐sequence induction of anaesthesia. We performed this study to answer the question – are there clinically relevant differences between the use of rocuronium and succinylcholine to secure acceptable intubating conditions during rapid‐sequence induction of anaesthesia with propofol? Methods: Anaesthesia was induced using propofol 2.5 mg/kg in 349 ASA physical status grade I–IV patients who were undergoing either elective or emergency surgery. Propofol was followed immediately by either rocuronium 0.6 or 1 mg/kg or succinylcholine 1.0 mg/kg (randomly selected). Fifty seconds after the end of muscle relaxant injection laryngoscopy was performed and intubating conditions were graded by an experienced anaesthetist blind to the muscle relaxant allocation. This study design was selected so that a 10% difference in clinically acceptable intubating conditions between drugs would be detectable. Results: In this setting rocuronium 1.0 mg/kg provided superior intubating conditions compared with rocuronium 0.6 mg/kg. The incidence of clinically acceptable intubating conditions with rocuronium 1.0 mg/kg and succinylcholine 1.0 mg/kg was 93.2% and 97.1% respectively, the difference being −3.9% (95% C.I. −9.7% to 1.9%). Conclusion: Rocuronium 1.0 mg/kg given along with propofol in a rapid‐sequence induction of anaesthesia is clinically equivalent to succinylcholine 1.0 mg/kg.