Comparative Study of Two Different Doses of Rocuronium Bromide with Suxamethonium Chloride for Endotracheal Intubation

Introduction: Suxamethonium chloride was a time-tested depolarizing muscle relaxant with quick onset of action and produced excellent intubating conditions but it is contraindicated and hazardous in certain situations. Rocuronium bromide had the most rapid onset, intermediate duration of action, minimal cardiovascular side effects, and no histamine release emerged as a good alternative. Purpose of the Study: To evaluate the efficacy of two different doses of rocuronium bromide in comparison to suxamethonium chloride on the intubating conditions, with emphasis on the duration of action, hemodynamic changes after intubation, and occurrence of any untoward side effects with either drug. Methods: This was a randomized clinical study conducted at a tertiary care center. 90 patients posted for elective surgeries were divided into groups of 30 each. Depending on the dose of the muscle relaxant Group S received succinylcholine 1.5 mg/kg, Group R6 and R8 received rocuronium bromide 0.6 mg/kg and 0.8 mg/kg, respectively. Laryngoscopy and intubation were done with an appropriate size oral endotracheal tube at 60 s. Relaxation of jaw, vocal cords, and response to intubation were assessed at 60 s and scored using a standard intubation scoring system after injection of the study drug. Results were tabulated and analyzed using mean, standard deviation, and Chi-square test. Results: We observed excellent intubating conditions in 100% of Group S, 86.66% and 93.33% in Group R6 and R8, respectively. The duration of action of rocuronium 0.6 mg/kg was shorter than 0.8 mg/kg. Thus, increasing the dose led to a longer duration of action. Hemodynamic changes returned to preinduction baseline values by the end of 10 min in all three groups. Conclusion: Rocuronium at both doses of 0.6 mg/kg and 0.8 mg/kg produced clinically acceptable intubating conditions and can be used as a safer alternative to succinylcholine in situations where it is contraindicated.