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Name | A randomised trial comparing quality of intubating conditions using rocuronium bromide and suxamethonium in elective surgeries |
Description | Research article:-Anaesthesia Rasquinha Vinay .J 1* ,Sheik Mohammed Salman1 ,Vasantha O.T1,Suranjith Sorake1 & Harish.B.Hegde2 1Assistant Professor,2Professor, Department of Anaesthesia, Yenepoya Medical College, Deralakatte, Mangalore 575018. Karnataka, India.
Abstract:- Background: Succinylcholine (Suxamethonium) is regarded as the drug of choice in all Rapid Sequence Induction (RSI) because its onset of action is less than 60 seconds for ideal intubating conditions. Rocuronium bromide, a non depolarizing muscle relaxant, has recently been used as substitute, in many cases where succinylcholine is contraindicated. Objective: To compare the quality of neuromuscular blockade for acceptable intubating conditions using rocuronium bromide with that of succinylcholine, at the end of 60 seconds in elective cases undergoing general anesthesia. Materials and Methods: This was a prospective comparison involving 50 patients in total coming for surgery under general anesthesia from Yenepoya Medical College. They were randomly divided into 2 equal groups of 25 each - Group 1 received succinylcholine 1mg.kg-1 and Group 2 received rocuronium bromide 0.6 mg.kg-1 .Each group received thiopentone sodium 5mg.kg-1 for induction. Each patient was evaluated for quality of intubating conditions at the end of 60 seconds by the scale from Cooper et al. and graded from a scale using 3 factors (jaw relaxation, vocal cord position and response to intubation).Each factor was given a score from 0-3. A total score of 8-9 was considered excellent intubating conditions, while scores of 6-7 were considered as good intubating conditions. Both excellent and good intubating conditions were considered acceptable intubating conditions. Scores below this were considered unacceptable (3-5 was fair and 0-2 were poor intubating conditions). Results: There was a statistically significant difference between Group 1 and Group 2 in terms of quality of intubating conditions at 60 seconds. Succinylcholine gave acceptable intubating conditions in 25 out of 25 patients while rocuronium bromide gave acceptable conditions in 19 out of 25 patients (p=0.02). Conclusion:- Our study concludes that succinylcholine (1mg.kg-1) produces superior intubating conditions as compared to rocuronium bromide (0.6mg.kg-1) at the end of 60 seconds.
Keywords:- Succinylcholine ; Rocuronium ; Muscle relaxant ; Intubation.
References:- 1. Cooper R, Mirakhur RK, Clarke RS, Boules Z. Comparison of intubating conditions after administration of Org 9246 (rocuronium) and suxamethonium. Br J Anaesth 1992; 69:269-73. PMID: 1389845. 2. Perry JJ, Lee JS, Sillberg VA, Wells GA. Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database of Syst Rev 2008 Apr 16;(2):CD002788. DOI: 10.1002/14651858.CD002788.pub2. PMID: 18425883 3. O'Kelly B, Fiset P, Meistelman C, Ecoffey C. Pharmacokinetics of rocuronium bromide in paediatric patients. Eur J Anaesthesiol Suppl 1994; 9:57-8. PMID: 7925210 4. McCourt KC, Salmela L, Mirakhur RK, Carroll M, Mäkinen MT , Kansanaho M, Kerr C, Roest GJ, Olkkola KT. Comparison of rocuronium and suxamethonium for use during rapid sequence induction of anaesthesia. Anaesthesia 1998; 53:867–71.PMID:9849280 .doi:10.1046/j.1365-2044.1998.00342.x. 5. Shukla A, Dubey KP, Sharma MSN. Comparative evaluation of haemodynamic effects and intubating conditions after the administration of ORG 9426 and succinylcholine. Indian Journal of Anaesthesia 2004; 48:476-9.
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