Comparison of intubating conditions after rocuronium or vecuronium when the timing of intubation is judged by clinical criteria

Abstract

The onset of action and intubating conditions after rocuronium 0.6 mg kg-1 or vecuronium 0.1 mg kg-1 were compared in a randomized, double-blind study when the timing of tracheal intubation was determined by clinical judgment alone. Times to laryngoscopy and completion of intubation were mean 89 (SD 20) s and 119 (28) s, respectively, in the rocuronium group compared with 110 (26) s and 142 (32) s in the vecuronium group (P < 0.05 in both cases). Rocuronium also resulted in significantly better intubating conditions compared with vecuronium but with no significant reduction in the haemodynamic response to intubation. We found that onset of satisfactory intubating conditions after rocuronium was detected clinically, although even earlier intubation should be possible by careful timing or by neuromuscular monitoring.