COMPARISION OF ONSET OF ACTION, DURATION AND INTUBATING CONDITIONS OF ROCURONIUM BROMIDE AND SUCCINYLCHOLINE IN ADULT PATIENTS.

罗库溴铵 罗库溴铵 医学 麻醉 插管 起效 择期手术 气管插管 肌肉放松 肌肉松弛剂 全身麻醉 恶性高热 外科
作者
Prashant Kumar,Sharad Srivastava,Manu Bhardwaj
出处
期刊: 卷期号:: 12-15
标识
DOI:10.36106/ijsr/2312306
摘要

Background: The major uses of muscle relaxation for surgery are: to facilitate endotracheal intubation and to provide surgical relaxation. Succinylcholine, with its rapid onset time, excellent intubating conditions, and short duration of action is a favourite of many anaesthesiologists for rapid endotracheal intubation. However, it falls short of the status of the ideal muscle relaxant - due to its life-threatening side effects such as hyperkalaemia, cardiac arrest and malignant hyperthermia. Rocuronium may serve as a useful alternative for many clinicians to facilitate endotracheal intubation, not only in elective cases under adequate anaesthesia, but also in emergency situations requiring rapid sequence intubation. The side effect prole of Rocuronium is way more limited, and way more acceptable to that of succinylcholine. While there have been many studies on the dosage of Rocuronium greater than /equal to 1mg/kg, which have demonstrated comparable onset and intubating conditions to succinylcholine, this study involves a lower dose(0.9mg/kg) elective surgery cases, where a minor difference in the time of onset is of no signicant concern. Objective: To compare onset of action, duration and intubating conditions of Rocuronium Bromide (0.9mg/kg) and Succinylcholine (1.5mg/kg) in adult ASA I and II patients posted for elective surgery. Method: this was a randomized, double-blind, prospective, clinical study conducted on 100 ASAI and II patients posted for elective surgery. Patients were divided into two groups using 'slips in the box technique': Group A– received Rocuronium bromide 0.9 mg/kg Group B – received Succinylcholine 1.5mg/kg Results: Ÿ The intubating conditions using Goldberg's score were acceptable in both groups= excellent or good conditions. Ÿ But the Succinylcholine group had more instances of excellent intubating conditions, and this difference was statistically signicant. p<0.05 Ÿ The Mean arterial pressure increased after laryngoscopy in both groups, but its difference between the two groups was not statistically signicant at any time interval. p >0.05 Ÿ In the Rocuronium group, 6 patients had signicant tachycardia. HR>120, and 5 patients had hypotension (MAP<60mm Hg) Ÿ In the Succinylcholine group, 7 patients had signicant tachycardia. HR>120, and 6 patients had hypotension (MAP<60mm Hg). Conclusion: this study reveals that Rocuronium, at a dose of 0.9mg/kg, is an effective substitute for Succinylcholine as the choice of muscle relaxant, and offers similar intubating conditions, at 1 minute. Considering the lower side effect prole, Rocuronium at the dose of 0.9 mg/kg can be the ideal choice for muscle relaxant during elective surgery

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