Comparison of Onset Time and Intubating Conditions Achieved with Succinylcholine 1.5mg/kg and Rocuronium 0.6mg/kg & 0.9mg/kg IV

Esther Sudharshini, R (2008) Comparison of Onset Time and Intubating Conditions Achieved with Succinylcholine 1.5mg/kg and Rocuronium 0.6mg/kg & 0.9mg/kg IV. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Neuromuscular blocking agents are commonly used to facilitate tracheal intubation. A perfect setting for tracheal intubation include a rapid onset, profound paralysis of all muscles and short duration of action so that the patients own respiratory function can be restored should intubation prove to be impossible. These requirements are best met by succinylcholine, an ultrashort acting depolarizing muscle relaxant. However its many unwanted side effects have necessitated a search for an alternative drug or technique to facilitate tracheal intubation. The introduction of each new muscle relaxant has advanced anaesthetic practice by trying to meet some perceived deficiency in the existing therapeutic armamentarium. Rocuronium bromide is a steroid, non-depolarizing neuromuscular blocking agent with a rapid onset and an intermediate duration of action. It may be a suitable alternative to succinylcholine. AIM OF STUDY: To study and compare the efficacy of rocuronium bromide in two dosage schedules – 0.6mg / kg (2 x ED95) and 0.9mg / kg (3 x ED95) IV, with succinylcholine chloride 1.5mg / kg IV in patients with respect to: 1. Intubating conditions at one minute, 2. Onset of action, 3. Adverse effects. MATERIALS AND METHODS: This study was conducted at Government Stanley Hospital, Chennai, in the patients undergoing general surgical procedures. After institutional approval and informed consent, 60 patients were enrolled in the study. Inclusion Criteria: All ASA Physical status 1 and 2 patients aged between 20-60 years scheduled for elective surgery under general anaesthesia. Exclusion Criteria: • Modified Mallampatti Airway Classification III, IV. • Morbidly Obese, • Pregnant women, • Neuromuscular disease, • Hepatic or renal disease, • Patients receiving any medication known to interact with neuromuscular blocking agents. SUMMARY: Succinylcholine 1.5mg/kg IV gave a significantly higher incidence of excellent intubating conditions than either 0.6 mg or 0.9 mg/kg Rocuronium IV (100% vs 30% vs 85%) respectively. • Rocuronium 0.9 mg/kg IV produced intubating condition similar to Succinylcholine 1.5mg/kg. • Rocuronium 0.6 mg/kg IV did not produced adequate intubating condition. • Succinylcholine 1.5mg/kg IV had a quicker onset (43.75 ± 3.582) sec than either dose of Rocuronium0.9mg/kg (105.5±22) and Rocuronium 0.6mg/kg(220.75 ± 51) seconds. • No evidence of histamine release was observed in any of the patients in three groups. • The cost factor is high with Rocuronium Compound to Succinylcholine. CONCLUSION: • Succinylcholine is an ideal agent for intubation in all surgical procedures. • Intubating conditions of Rocuronium bromide at a dose of 0.9mg/kg (3xED95) is comparable to Succinylcholine 1.5mg/kg at 1minute. • Rocuronium bromide 0.9 mg/kg can be used safely in patients where Succinylcholine is contraindicated.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Onset Time ; Intubating Conditions Achieved ; Succinylcholine 1.5mg/kg ; Rocuronium 0.6mg/kg ; 0.9mg/kg IV ; Comparison Study.
Subjects: MEDICAL > Anaesthesiology
Depositing User: Subramani R
Date Deposited: 22 Apr 2018 15:43
Last Modified: 28 Apr 2018 05:39

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