A comparison study of vecuronium bromide and atracurium besylate for rapid sequence induction

Rapid sequence induction is necessary in emergency surgical operations to lessen the chance of aspiration of stomach contents. Succinylcholine usually is the relaxant of choice, because of its rapid onset. However, succinylcholine has side effects which may result in potentially life-threatening conditions. The purpose of this study was to compare two short-acting non-depolarizing muscle relaxants-vecuronium and atracurium, using the priming principle, with a depolarizing muscle relaxant, succinylcholine. The comparison may determine if a more suitable method for rapid sequence induction can be identified. Conditions at intubation and at the time to 80-90% neuromuscular blockade were evaluated. Subjects were intubated when the train of four revealed an 80-90% twitch depression. In Group I, the control group using succinylcholine, the mean time to 80-90% neuromuscular block was 74.8 seconds. In Group II subjects, who had received vecuronium, the mean time was 149.4 seconds. Subject in Group III, who received atracurium, had a mean time of 163.7 seconds. There was statistical significance within all three groups (ANOVA, p less than 0.01). Group I subjects showed a significantly faster time to 80-90% neuromuscular block when compared with subjects in Group II and III, but no difference in the time to 80-90% block was revealed between Group II and Group III subjects. Conditions for intubation at 80-90% neuromuscular blockade were the same for all three groups. It was concluded that the administration of vecuronium and atracurium using the priming principle did not allow onset times similar to succinylcholine and that the intubating conditions were similar among all three groups at 80-90% neuromuscular blockade.