Intubating conditions, onset, duration and side effects with rocuronium and atracurium: A comparative

  • Dr. Rashmi Naik Associate Professor, Department of Anesthesiology and Critical Care, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
  • Dr. Rashmi Thakur Associate Professor, Department of Anesthesiology and Critical Care, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
  • Dr. K.K. Sahare Professor, Department of Anesthesiology and Critical Care, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
  • Dr. A.M. Lakra Professor, Department of Anesthesiology and Critical Care, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
  • Dr. Deepak Singh Associate Professor, Department of Anesthesiology and Critical Care, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
  • Dr. C.P. Bhagat Assistant Professor, Department of Anesthesiology and Critical Care, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
Keywords: Rocuronium, Atracurium, Intubating condition, Neuromuscular blocking agent

Abstract

Objective(s): To compare the intubating conditions, onset and duration of action, side effects and complications with rocuronium bromide and atracurium besylate.

Material and Method: This prospective, randomized double blind study was conducted with a sample size of 100 patients. After standard general anaesthesia technique group I received IV. rocuronium bromide 0.6 mg/kg and group II received iv. atracurium besylate 0.5 mg/kg. Laryngoscopy was attempted60 sec after administration of NMBA and thereafter every 30 sec till good or excellent intubating conditions were achieved. Intubating condition was scored on fourpoint scale (0-3). Intubating conditions, onset and duration, side effects and complications were observed and recorded.

Result: Overall intubating condition was acceptable (excellent + good) in 50(100%) patients in group I and 47(94%) patients in group II. It was excellent in 45(90%) and 16(32%) patients in group I and II respectively. Good intubating condition was found in 5(10%) and 31(62%) patients in group I and II respectively. Fair intubating condition was found in 3(6%) patients in group II. None of the patients had poor intubating condition in either group. Cutaneous flushing was found in 4% cases in group II. No other side effects and complications were observed.

Conclusion: Rocuronium with its faster initial response and possibly early laryngeal muscle paralysis provides better intubating conditions in shorter duration of time than atracurium.

Downloads

Download data is not yet available.

References

Fuchs-Buder T. and Tassonyi E. Intubating conditions and time course of rocuronium-induced neuromuscular block in children. Br J Anaesth. 1996;77:335-38.

Savarese JJ. and Kitz RJ. Does clinical anesthesia need new neuromuscular blocking agents? Anesthesiology 1975;42 (3):236-39.

Stoelting R.K. Neuromuscular blocking drugs pharmacology and physiology in Anaesthetic practice. Lippincott Raven USA 3rd Edition, 1999;182-23.

Cooper R., Mirakhur R. K., Clarke R. S. J.and Boules Z. Comparison of intubating conditions after administration of ORG 9426 (rocuronuium) and suxamethonium. Br. J. Anaesth. 1992;69:269-73.

Payne JP, Hughes R. Evaluation of atracurium in anaesthetized man. Br J Anaesth. 1981 Jan;53(1):45-54.

Darshna D Patel and Varsha N Swadia. Rocuronium bromide versus vecuronium bromide: Comparison of onset, intubatimg condition and duration of action. Int J Res Med. 2013;2(2):137-41.

ElbradieSamia. Neuromuscular efficacy and histamine release hemodynamic changes produced by rocuronium vs atracurium: A comparative study. Journal of Egyptian Nat. cancer Inst. 2004;16:107-13.

Whalley DG, Maurer WG, Knapik AL, et al. Comparison of neuromuscular effects, efficacy and safety of rocuronium and atracurium in ambulatory anaesthesia. Can J Anaesth. 1998 Oct;45(10):954-9. DOI: https://doi.org/10.1007/BF03012303.

Mirakhur RK, Lavery GG, Clarke RS, et al. Atracurium in clinical anaesthesia: effect of dosage on onset, duration and conditions for tracheal intubation. Anaesthesia. 1985 Aug;40(8):801-5.

Bunburaphong P., Werawataganon T and Panyarachun K. Intubating conditions after three different doses of rocuronium in elderly. Can J. Anaesth.1998; 45(10): 954-9.

Plaud B, Proost JH, Wierda JM, et al. Pharmacokinetics and pharmacodynamics of rocuronium at the vocal cords and the adductor pollicis in humans. Clin PharmacolTher. 1995 Aug;58(2):185-91. DOI: https://doi.org/10.1016/0009-9236(95)90196-5.

Pühringer FK, Sparr HJ, Mitterschiffthaler G, et al. Extended duration of action of rocuronium in postpartum patients. AnesthAnalg. 1997 Feb;84(2):352-4.

Saxena, A.H. Rocuronium bromide: a clinical trial. J. Anaesth. Clin. Pharmacol. 1999 Apr.;15(2):183-85.

Singh Ajeet and Bhatia Pradeep Kumar. Comparision of onset time, duration of action and intubating conditions with suxamethonium and rocuronium. Indian. J. Anaesth.2004;48(2):129-33.

Meistelman Claude, Plaude B. andDonati F. Rocuronium (ORG 9426) neuromuscular blockade at the adductor muscles of larynx and adductor pollicis in humans. Can I. Anaesth.1992 Sep;39(7):665-69.

Khuenl-Brady KS, Pomaroli A, Pühringer F, et al. The use of rocuronium (ORG 9426) in patients with chronic renal failure. Anaesthesia. 1993 Oct;48(10):873-5.

Sehgal Arun, Sharma R.K. and Kumar Indrani. Comparison of intubating conditions and time course action of Rocuronium Bromide and Vecuronium Bromide. Ind. J. Anaesth.2001;45(4):255-58.

Awasthi S.N., Swe K.K. and Kyi D.W. Initial clinical experience with atracurium. Ind J. Anaesth.1987;35(2):128-32.

Bharti Neeraja, Sharma Sunil, Goel S.K. and Deepak Falgune. Rocuronium: Time course of action and intubation conditions, - A comparison with atracurium and vecuronium. Indian J. Anaesth.2001;45(5):363.

Wierda JM, de Wit AP, Kuizenga K, et al. Clinical observations on the neuromuscular blocking action of Org 9426, a new steroidal non-depolarizing agent. Br J Anaesth. 1990 Apr;64(4):521-3.

Intubating conditions, onset, duration and side effects with rocuronium and atracurium: A comparative
CITATION
DOI: 10.17511/ijmrr.2018.i08.11
Published: 2018-12-31
How to Cite
1.
Naik R, Thakur R, Sahare K, Lakra A, Singh D, Bhagat C. Intubating conditions, onset, duration and side effects with rocuronium and atracurium: A comparative. Int J Med Res Rev [Internet]. 2018Dec.31 [cited 2024Nov.23];6(8):464-70. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1020
Section
Original Article