ROCURONIUM VERSUS SUCCINYLCHOLINE - ARE THEY EQUALLY EFFECTIVE DURINGRAPID-SEQUENCE INDUCTION OF ANESTHESIA

The purpose of our study was to assess the onset and quality of muscle paralysis and intubation conditions with succinylcholine (Sch) or roc uronium (Roc) during rapid-sequence induction. Patients were randomly assigned to receive thiopental (5 mg/kg) and Sch (1.5 mg/kg) or thiope ntal (5 mg/kg) and Roc (1.2 mg/kg). The anesthesiologists performing t he endotracheal intubation were blinded by standing with their back to the patient. Thirty seconds after drug administration, laryngoscopy w as performed. Intubating conditions were scored, the clinical onset of apnea was noted, and a train-of-four monitor recorded data. All patie nts were ASA physical status I-III and scheduled for emergency procedu res; both groups were demographically similar. Thirteen patients recei ved Roc and 13 received Sch. There was no significant difference betwe en the two groups in the number of patients receiving excellent intuba ting scores (P = 0.41) or in the combined number of patients receiving good and excellent scores (P = 1.0). There was no significant differe nce in time of onset of apnea for Sch (22 +/- 13 s) versus Roc (16 +/- 8 s). The return of the first twitch response was significantly faste r with Sch(5.05 +/- 2.5 min) compared with Roc (173 +/- 21.7 min) (P = 0.0001). Implications: Ln pediatric patients scheduled for emergency surgery, thiopental 5 mg/kg and rocuronium 1.2 mg/kg provided conditio ns for the completion of intubation in <60 s comparable to those provi ded by thiopental 5 mg/kg and succinylcholine 15 mg/kg. We conclude th at rocuronium is a reasonable substitute for succinylcholine in childr en for rapid-sequence intubation when a rapid return to spontaneous re spiration is not desired.