Comparison of vecuronium or rocuronium for rapid sequence induction in morbidly obese patients: a randomized study

Abstract

Background: This trial aimed to evaluate the effect of the use of triple the ED95 of rocuronium and vecuronium on the onset of relaxation and the intubation score in morbidly obese patients. Methods: Sixty adult morbidly obese patients were included in this trial and were randomly assigned according to the muscle relaxants used to the ROC group, in which patients received rocuronium (0.9 mg/kg), and VEC group, in which the patients received vecuronium (0.15 mg/kg). The onset and duration of relaxation, the time of intubation, and the intubation scores were assessed. Additionally, the response of hemodynamic parameters to the injection of muscle relaxants and to the intubation was recorded. Results: The onset of relaxation was significantly lower in ROC group (57.5 ± 19.9 sec) than in VEC group (105.0 ± 18.8 sec) (P < 0.0001). Additionally, the time for intubation was significantly shorter in ROC group (69.00 ± 19.4 sec) than in VEC group (120.8 ± 17.7 sec) (P < 0.0001). Moreover, there was a significant increase in the duration of relaxation in ROC group (85.5 ± 19.2 min) compared with VEC group (72.00 ± 22.65 min) (P = 0.016). However, there was no significant difference between the two groups in the intubation score (P = 0.656) and the changes in the hemodynamic parameters (P > 0.05). Conclusion: The use of triple the ED95 of rocuronium in morbidly obese patients significantly shortened the onset of relaxation and the timing of intubation compared to vecuronium. However, the intubation score and the hemodynamic changes during intubation were comparable.