Comparative Evaluation of Intubating Conditions and Haemodynamic Effects after the Administration of Succinylcholine and Rocuronium Bromide.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2017, Vol 2, Issue 6
Abstract
Background: Suxamethonium has been the gold standard depolarizing muscle relaxant for rapid sequence enotracheal intubation. Due to its many side effects, like, muscular fasciculations, bradycardia, dysrhythmia, hyperkalemia, rise in intra ocular, intracranial and intrgastric pressure, incidence of prolong recovery in patients with pseudocholinestarase deficiency and malignant hyperthermia, alternative of suxamethonium are being studied. Rocuronium, an intermediate acting non-depolarizing muscle relaxant, is being studied as an alternative to suxamethonium for endotracheal intubation beacause of its lesser side effects. Aims and objectives: Observe and compare the intubating conditions, onset of time, duration of action & haemodynamic effect in patients receiving succinylcholine and rocuronium bromide in different doses for rapid tracheal intubations. Methods: Sixty patients were divided in three groups according to the muscle relaxant used for endotracheal intubation for general anesthesia for elective surgeries: Group I Patients (n=20) received succinylcholine chloride 1.5 mg/kg intravenous (IV), group II Patients (n=20) received rocuronium Bromide 0.6 mg/kg IV and group III Patients (n=20) received rocuronium Bromide 0.9 mg/kg IV. Peripheral nerve stimulator was used to monitor the effect of muscle relaxants. Onset time and duration of action of the muscle relaxant, intubating condition, time to intubate and hemodynamic parameters were recorded. Data compared statistically. Results: The mean onset time for group I was 45.5 (±8.87) seconds, for group II was 87.5 (± 13.32) seconds and for group III was 70 (±16.88) seconds and was statistically significant between the three groups. Clinical duration of intubating dose of 0.6 mg/kg rocuronium was significantly lesser than that of rocuronium 0.9 mg/kg (35.68 ± 3.84 minutes vs 53.65 ±4.18 minutes, p<0.01). The intubating conditions were graded as excellent in 19 (95%), 12 (60%) and 18 (90%) patients of group I, II and III respectively. Heart rate and mean arterial pressure remained statistically insignificant between the groups. Conclusion: rocuronium is not a remedy for all intubation nor a replacement for traditional succinylcholine but there is growing body of evidence that suggest its equivalence to or superiority over conventional succinylcholine.
Authors and Affiliations
Shah Rajkiran B.
Keywords
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