Rocuronium versus succinylcholine-atracurium for tracheal intubation and maintenance relaxation during propofol anesthesia

Study Objectives: To compare the onset and offset time (clinical duration), and intubating conditions obtained with rocuronium bromide 0.6 mg/kg and s uccinylcholine 1.0 mg/kg after induction with propofol and fentanyl; and to compare rocuronium with atracurium for maintenance during propofol anesthe sia. Design: Prospective, open-label, parallel group comparative, randomized stu dy. Setting: Operating rooms of a university hospital. Patients: 30 ASA physical status I and II adult patients scheduled for elec tive surgeries with general anesthesia. Interventions: Patients premedicated with midazolam 2 mg were anesthetized with fentanyl 2 mug/kg followed by propofol 2.5 mg/kg and muscle relaxants. Group 1 (n = 15) received succinylchloline 1.5 mg/kg and Group 2 (n = 16) received rocuronium bromide 0.6 mg/kg. Intubation was performed 60 seconds after the administration of muscle relaxant. Patients in Group 1 received a tracurium and patients in Group 2 received rocuronium for maintenance if re quired. Measurements: The ease of intubation was scored using a scale of 1 to 4. On set and offset time monitored with evoked twitch response of the adductor p ollicis were recorded. Main Results: Intubation was successful in all patients and there was no di fference in scores between the two groups. Although onset time was shorter with succinylcholine than with rocuronium, neuromuscular blockade was succe ssfully antagonized in both groups, and the recovery profile was not differ ent between the two groups. Conclusions: Rocuronium bromide at a nose of 0.6 mg/kg, when used with prop ofol and fentanyl for induction provides intubating conditions similar to s uccinylcholine 1.0 mg/kg at 1 minute The actual onset time and offset time, however, are significantly longer with rocuronium. There was no difference between atracurium and rocuronium as a maintenance drug Rocuronium is suit able for surgical procedures greater than 30 minutes, eliminating the need for an additional relaxant to succinylcholine. (C) 2000 by Elsevier Science Inc.