COMPARISON OF ROCURONIUM AND SUXAMETHONIUM FOR USE DURING RAPID-SEQUENCE INDUCTION OF ANESTHESIA

This study was designed to compare the tracheal intubating conditions during a rapid sequence induction of anaesthesia using rocuronium 0.6 (n = 61) or 1.0 mg.kg(-1) (n = 130) or suxamethonium 1.0 mg.kg(-1) (n = 127) as the neuromuscular blocking drugs. Anaesthesia was induced wi th fentanyl 1-2 mu g.kg(-1) and thiopentone 5 mg.kg(-1) (median dose) and intubating conditions were assessed 60 s after the administration of the neuromuscular blocking drug by an observer unaware of which dru g had been given. Intubating conditions were graded on a three-point s cale as excellent, good or poor, the first two being considered clinic ally acceptable. The study was carried out in two parts. At the end of the first part a comparison between the two doses of rocuronium was c arried out when at least 50 patients had been enrolled in each group. The results showed the intubating conditions to be significantly super ior with the 1.0 mg.kg(-1) dose of rocuronium (p < 0.01). Final compar ison between the 1.0 mg.kg(-1) doses of rocuronium and suxamethonium s howed no significant difference in the incidence of acceptable intubat ions (96 and 97%, respectively). The incidence of excellent grade of i ntubations was, however, significantly higher with suxamethonium (80% vs. 65%; p = 0.02). It is concluded that rocuronium 1.0 mg.kg(-1) can be used as an alternative to suxamethonium 1.0 mg.kg(-1) as part of a rapid sequence induction provided there is no anticipated difficulty i n intubation. The clinical duration of this dose of rocuronium is, how ever, 50-60 min.