Comparative study of intubating conditions and hemodynamic effects after administration of rocuronium and succinylcholine for endotracheal intubation in adult patients for elective surgeries: A randomized control study

Background and Objective: Rocuronium provides faster neuromuscular blockade compared with other neuromuscular blocking drugs. It produces comparable intubating conditions to that of Succinylcholine conditions depending upon the dose administered. In our study, the effects of Rocuronium 0.9 mg/kg (3x ED95) was compared with Succinylcholine 2 mg/kg when used for endotracheal intubation in adult patients for elective surgeries under general anesthesia and assessed the hemodynamic stability. Method: A prospective double blinded randomized controlled study was conducted at KVG medical college hospital, Sullia on 60 Adult patients 30-50yrs of age with ASA I or II grades who were undergoing elective surgeries under general anesthesia. Patients were premedicated with glycopyrrolate 0.2 mg intravenous. Patients randomly received either succinylcholine 2 mg/kg or rocuronium 0.9 mg/kg after induction with propofol 2 mg/kg and fentanyl 2µg/kg intravenously. Onset of action was assessed with adequate jaw relaxation. Intubating conditions and the time to intubation was assessed by modified grading given by Cooper et al. Hemodynamic changes were noted before and after intubation. Results: We observed that succinylcholine chloride 2 mg/kg body weight and rocuronium bromide 0.9 mg/kg body weight produced well to excellent intubating conditions in all patients. Rocuronium bromide 0.9 mg/ kg body weight showed excellent intubating conditions in 83.4% of patients, which was comparable to that of 83.33% observed with succinylcholine chloride. Onset of action (60 sec) was faster with succinylcholine in 73.3% of patients than with rocuronium 66.7%. There was a transient rise in the hemodynamic variables but was not statistically significant 5 minutes after induction. Conclusion: Rocuronium 0.9 mg/kg provides good to excellent intubating conditions in 60 – 90 seconds with no hemodynamic side effects and is a better alternative to succinylcholine for intubation in patients where succinylcholine chloride is contraindicated.