A Comparative Study of Pre-Induction Rocuronium With Post-Induction Succinylcholine for Rapid Sequence Intubation in Emergency Surgeries

Abstract

BACKGROUND Rapid Sequence Intubation (RSI) is the demand for emergency surgeries. Many investigators leveled Succinylcholine as the gold standard for the RSI intubation. But in most of those studies, both Succinylcholine and Rocuronium were used post-induction and the dose of Rocuronium varied. Hence, the present study is designed to compare the intubating condition achieved by preinduction Rocuronium 1 mg/ kg body weight vs. post-induction Succinylcholine 1.5 mg/kg body weight and to determine whether Rocuronium can be the suitable alternative to Succinylcholine in RSI intubation. MATERIALS AND METHODS The study was designed, 1. To compare the intubating condition achieved by Rocuronium and Succinylcholine during rapid sequence intubation for emergency surgeries. 2. To find out whether Rocuronium can be the suitable alternative to Succinylcholine. 144 consenting patients of ASA-I and ASA-II of either sex and age group of 18-45 yrs. were taken up for the study. RESULTS There was no significant difference in intubation conditions achieved by either drug. Induction to vocal cord paralysis time was little shorter with succinylcholine than Rocuronium, but statistically insignificant. However, paralysis caused by Rocuronium lasted for longer extent of time (35-52 mins.), whereas paralysis of Succinylcholine recovered spontaneously after 5-10 mins. CONCLUSION Rocuronium may be recommended as an alternative to Succinylcholine if used pre-induction with 1 mg/kg BW for RSI intubation and advantageous for emergency surgeries of approximate one-hour duration or more.

Analysis of onset time and intubating conditions following intravenous administration of Rocuronium 0.6mg/kg and Rocuronium 0.9mg/kg doses and its comparison with Succinylcholine 1.5mg/kg for Rapid Sequence Induction

“…The result was similar to other studies. 4,5,7,[11][12][13][14][15][16] Variable results was found in other study 17 , which caused due to different doses.…”

Comparison of Rocuronium and Succinylcholine for Rapid Sequence Induction in patients undergoing surgery under General Anaesthesia

“…Another study by Sutradhar B et al 9 and a local study by Ahad A et al 12 and showed that rocuronium produces equally good intubating conditions when compared to succinylcholine. Another study by Mencke T et al 10 showed that with succinylcholine, 57% cases had excellent intubation conditions compared with 21% in case of rocuronium, while clinically acceptable conditions with succinylcholine were 89% compared to 59% of cases in rocuronium group The difference was found to be significant (p=0.001) and showed that succinylcholine is more effective.…”

“…The Succinylcholine group showed significantly better intubating conditions as compared to the rocuronium group. A study conducted by Larsen PB et al 9 showed different results. This study showed that clinically acceptable conditions were present in 93.5% of patients in the succinylcholine group whereas 96.1% of patients in the rocuronium group (P=0.59).…”