A comparative study of intubating conditions using succinylcholine and two doses of rocuronium

To secure and maintain a patent airway is the prime role of anaesthesiologists. Succinylcholine, because of its ultra-rapid onset and ultra-short duration of action has been the main neuromuscular blocking agent and is considered the gold standard for tracheal intubation. Certain undesired adverse effects of succinylcholine have led to the search for an ideal substitute for this drug. Rocuronium bromide, a relatively newer non-depolarizing muscle relaxant, owing to its rapid onset of action can be preferable to succinylcholine in order to avoid its adverse effects. The aim was to compare the onset time, duration of action, intubating conditions and haemodyanamic effects of rocuronium bromide with that of succinylcholine. A total of 90 adult patients of either sex aged between 20 to 60 years were selected randomly and divided into three groups. Group S received succinylcholine 1.5mg/kg, group R1 and R2 received rocuronium 0.6mg/kg and 0.8mg/kg respectively before intubation. The neuromuscular block was assessed by using train of four stimulation at adductor pollicis muscle every 20 seconds.We observed that both the onset time and duration of action was significantly shorter for succinylcholine group in comparison to rocuronium groups, and increasing the dose of rocuronium shortened the onset of muscle relaxation. The intubating conditions were clinically acceptable (excellent + good) in 100% of patients (excellent in 93%) of group S, 93% of patients (excellent in 53%) of group R1, and 100% of patients (excellent in 83%) of group R2.there was no significant change in heart rate and mean arterial pressure from the baseline value after the administration of muscle relaxants in either of the three groups. We conclude that rocuronium can be used as a safer alternative to succinylcholine for rapid tracheal intubation in conditions where the later is contraindicated or hazardous.