A prospective randomized study for comparison of onset time of intubation and intubating conditions using rocuronium with priming and without priming

Abstract

Background: Rocuronium, a non-depolarizing neuromuscular blocking agent, with priming, can be used as an alternative to succinylcholine for rapid sequence intubation because it produces rapid onset of intubation with comparable intubating conditions. We aimed to compare the onset time of intubation and intubating conditions using rocuronium with priming and without priming.

Methods: Sixty adult patients of either sex, aged 18-60 years, ASA grade I and II, scheduled for various elective surgeries under general anaesthesia were randomly allocated into two groups (30 patients in each group). Group P received 0.06 mg/kg of rocuronium as priming dose and Group C received normal saline as placebo before induction. The patients in both groups received fentanyl 1.5 µg/kg and induced with propofol 2.5 mg/kg. The intubating dose of rocuronium 0.54 mg/kg for Group P and 0.6 mg/kg for Group C were given after 3 min of priming. The time interval between the intubating dose and the loss of T1 of TOF stimuli was considered as the onset time of intubation and Cooper’s scoring system was used to compare the intubating conditions.

Results: The onset time of intubation was significantly shorter (P <0.05) in group P (54.87 ± 3.75 sec) than group C (94.37 ± 3.52 sec). Intubating conditions were found to be excellent in both the groups with no any adverse effects.

Conclusion: Rocuronium (0.6 mg/kg) with priming provides rapid onset time of intubation (<60 sec) along with excellent intubating conditions without any adverse effects which may be particularly useful for rapid sequence intubation and where succinylcholine is contraindicated.