Related Experiment Video
Updated: Oct 19, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Is the rapid sequence induction possible with 0.6 mg/kg rocuronium in pediatric patient?
Sang Kyu Lee1, Ji Hee Hong, Ae Ra Kim
1Department of Anesthesiology and Pain Medicine, Keimyung University College of Medicine, Daegu, Korea.
Insights
This study explored rocuronium for rapid sequence induction (RSI) in children. The timing of rocuronium administration did not significantly impact clinically acceptable intubation conditions.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Investigated rocuronium 0.6 mg/kg for rapid sequence induction (RSI) in pediatric patients.
- Focused on children aged 4-8 years undergoing elective surgery.
Purpose of the Study:
- To evaluate the efficacy of the timing principle in conjunction with rocuronium for pediatric RSI.
- To compare intubating conditions based on the sequence of rocuronium and propofol administration.
Main Methods:
- Randomized study of 65 children (aged 4-8 years) into two groups.
- Group A: Rocuronium (0.6 mg/kg) followed by propofol (2.5 mg/kg).
- Group B: Propofol followed by rocuronium (0.6 mg/kg); intubation assessed at 60 seconds.
Main Results:
- Excellent intubation conditions achieved in 87% (Group A) vs. 61% (Group B).
- Clinically acceptable intubation conditions (excellent and good) were comparable: 100% (Group A) vs. 99% (Group B).
- No significant difference in clinically acceptable intubation outcomes between the groups.
Conclusions:
- Rapid sequence induction (RSI) with rocuronium is feasible in pediatric patients regardless of the timing principle.
- The sequence of rocuronium and propofol administration does not critically affect successful intubation in this pediatric population.
- Rocuronium at 0.6 mg/kg provides effective intubating conditions for pediatric RSI.
Background:
We have investigated the possibility of rocuronium 0.6 mg/kg and timing principle application with the same dose for rapid sequence induction (RSI) in 65 children, aged 4-8 yr.
Methods:
Sixty five patients were randomly assigned to one of two groups; Group A (n = 31, timing principle application) received rocuronium (0.6 mg/kg) followed by administration of propofol (2.5 mg/kg), and group B (n = 36) received rocuronium (0.6 mg/kg) after administration of propofol. Intubation was assessed at 60 seconds just after administration of last injectants. Intubating conditions (jaw relaxation, vocal cord movement, and response to tracheal intubation) were evaluated as excellent, good, fair and poor.
Results:
Excellent intubation conditions were obtained in 87% in group A and 61% in group B. However, clinically acceptable intubation conditions which means excellent and good did not show any significant difference as 100% (group A) and 99% (group B).
Conclusions:
In cases of pediatiric patients undergoing elective surgery, RSI was possible irrespective of the use of timing principle.
More Related Videos
Related Concept Videos
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
Depolarizing Blockers: Mechanism of Action
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because succinylcholine...
Depolarizing Blockers: Pharmocokinetics
Skeletal Muscle Relaxants: Therapeutic Uses
Parenteral Anesthetics: Overview
Drug Dosing: Infants and Children

