Comparision of rocuronium bromide with suxamethonium chloride for tracheal intubation

Abstract

Background: Endotracheal intubation is of paramount importance in general anaesthesia requires relaxation of laryngeal musculature leading to total inactivity of vocal cords. Suxamethonium chloride, a depolarizing muscle relaxant due to its quick onset of action and excellent intubating conditions has remained a muscle relaxant of choice. Rocuronium was proved to be safe alternative to suxamethonium for endotracheal intubation. Aims & Objective: To find out the utility of Inj. Rocuronium Bromide a non-depolarizing muscle relaxant (NDMR) as an alternative to Suxamethonium chloride, a depolarizing muscle relaxant (DMR) for the purpose of intubation of trachea with emphasis on onset of time for muscle relaxation, duration of action, hemodynamic changes and complications if any. Materials and Methods: This is a randomized clinical study carried out at tertiary care center. 90 patients were randomly divided into three groups. Group {$[$}S.sub.60{$]$} (n=30)--Inj. Suxamethonium 1.5 mg/kg IV given I.V, Group {$[$}R.sub.60{$]$} (n=30)--Inj. Rocuronium 0.6 mg/kg IV given I.V and Group {$[$}R.sub.90{$]$} (n=30)--Inj. Rocuronium 0.6 mg/kg IV given I.V. The intubating conditions were judged clinically at fixed time interval i.e. either at 60 seconds or 90 seconds as per the group of patient, after the injection of study drug with the help of four point scale. The observed results were compiled and analyzed statistically by using chi-square test for qualitative data and students "t" test for quantitative data, the analysing system being that of EPI INFO. Results: The mean age was 29.2 {$[$}+ or -{$]$} 12.60, 28.83 {$[$}+ or -{$]$} 8.50 & 30.1 {$[$}+ or -{$]$} 10.47 years, respectively in {$[$}S.sub.60{$]$}, {$[$}R.sub.60{$]$} and {$[$}R.sub.90{$]$} group. Intubating conditions were excellent (score 8-9) in all the 30 patients (100%) in Group {$[$}S.sub.60{$]$}, in 23 patients (76.66%) of Group {$[$}R.sub.60{$]$} and in 28 patients (93.33%) of Group {$[$}R.sub.90{$]$}. The mean onset time in our study were 46.66 {$[$}+ or -{$]$} 5.46 seconds in Group {$[$}S.sub.60{$]$}, 76.33 {$[$}+ or -{$]$} 10.33 seconds in Group {$[$}R.sub.60{$]$} and 78.33 {$[$}+ or -{$]$} 9.4 in {$[$}R.sub.90{$]$}. The duration of action in our study was 5.93 {$[$}+ or -{$]$} 1.25 minutes in Group {$[$}S.sub.60{$]$} compared to 29.83 {$[$}+ or -{$]$} 5.49 minutes in Group {$[$}R.sub.60{$]$} and 27.83 {$[$}+ or -{$]$} 3.13 minutes in {$[$}R.sub.90{$]$}. Conclusion: Rocuronium can serve as a good alternative to Suxamethonium for tracheal intubation in conditions where Suxamethonium is contraindicated or where its use is hazardous. Key Words: Rocuronium; Suxamethonium; Tracheal intubation