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A Randomized Double-Blind Comparative Study of the Intubating Conditions and Hemodynamic Effects of Rocuronium and

Anil Kumar1, Arvind Kumar1, Alok K Bharti2

  • 1Anesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, IND.

Cureus
|October 6, 2023
PubMed

Insights

Rocuronium bromide at 1.2 mg/kg provided better intubating conditions and stable hemodynamics in pediatric patients compared to succinylcholine. This study highlights rocuronium as a safer alternative for pediatric airway management.

Area of Science:

  • Pediatric Anesthesiology
  • Pharmacology
  • Airway Management

Background:

  • Pediatric airways present unique challenges for intubation due to anatomical differences and congenital anomalies.
  • Rocuronium bromide offers a comparable onset of action to succinylcholine at appropriate doses.
  • Evaluating alternatives to succinylcholine is crucial for pediatric anesthesia.

Purpose of the Study:

  • To compare the efficacy of rocuronium bromide versus succinylcholine for tracheal intubation in pediatric patients.
  • To assess intubating conditions and hemodynamic stability between the two agents.
  • To identify potential adverse effects associated with each neuromuscular blocker.

Main Methods:

  • A randomized study involving 200 pediatric patients (1-14 years, ASA I-II) undergoing elective surgery.
  • Group R (n=100) received 1.2 mg/kg rocuronium; Group S (n=100) received 2 mg/kg succinylcholine intravenously.
  • Intubating conditions were assessed, and hemodynamic changes were recorded post-intubation.

Main Results:

  • Rocuronium group showed excellent (65%), good (25%), and fair (10%) intubating conditions.
  • Succinylcholine group had excellent (60%), good (20%), fair (15%), and poor (5%) conditions (p=0.010).
  • Significant heart rate increase occurred in the succinylcholine group; no significant blood pressure changes were noted in either group.

Conclusions:

  • Rocuronium bromide (1.2 mg/kg) is a superior alternative to succinylcholine for pediatric intubation.
  • Rocuronium facilitates rapid intubating conditions with improved hemodynamic stability.
  • This agent offers a favorable safety profile for pediatric airway management.
Abstract

Keywords:
airwaysintubationlaryngoscopypaediartic patientsrapid sequence inductionrocuronium bromidesuccinylcholine

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