Comparison of Suxamethonium with Rocuronium for Endotracheal Intubation
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2014, Vol 9, Issue 1
Abstract
Background: In the present day practice, muscle relaxation is used for facilitation of endotracheal intubation and to provide muscle relaxation throughout the surgery. Rocuronium bromide is a nondepolarizing aminosteroidal, vecuronium derivative drug with intermediate duration Side effects of suxamethonium are not observed with rocuronium bromide. Present study is aimed at determining the efficacy of rocuronium for routine endotracheal intubation within 60 seconds in general population. Objective: To compare the intubating conditions of rocuronium bromide with suxamethonium chloride. Methods: Patients were premedicated with inj. midazolam 0.05mg kg-1, inj. Pentazocine 0.5mg kg-1 and inj. glycopyrolate 0.005 mg kg-1, after which patients were preoxygenated for 03min with 100% oxygen. Induction was done with inj.thiopentone at the dose of 5mg kg-1. After loss of eye lash reflexes, muscle relaxant (rocuronium bromide/ suxamethonium chloride) was given as iv bolus. Intubating conditions were assesed at 60 seconds after injection of muscle relaxant, if intubating conditions were unsatisfactory, then repeat scopy was attempted after every 30sec interval (90, 120, 150 and 180 sec). Bag mask ventilation with 100% oxygen was continued till the repeat scopy was attempted. Monitoring of pulse rate, oxygen saturation, systolic and diastolic blood pressures, electrocardiogram were recorded immediately after laryngoscopy, at 5 and 10min after intubation. Results: Suxamethonium showed acceptable intubating conditions in 100% of cases at 60 Sec. out of which 93.24% were excellent. In rocuronium Group 100% of cases had acceptable intubating conditions at 60 sec. out of which 77.7% excellent and 22.2% good intubating conditions were observed. Conclusion: Rocuronium bromide at 0.9 mg kg-1 is a safe and good alternative for suxamethonium 1.5mg kg-1 for endotracheal intubation at 60 seconds. We advice rocuronium bromide 0.9 mg kg can be used for Rapid Sequence induction and Intubation, if there is no prediction of difficult intubation.
Authors and Affiliations
Pramod Bhale , Narender Bhandari , Selva Kumaran P , Rashmee Joshi
Keywords
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