Intubating conditions during rapid sequence induction with either rocuronium or suxamethonium in elderly patients. A...

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Pharmacology

Background:

• Rapid sequence induction (RSI) is critical for airway management.
• Rocuronium and suxamethonium are common neuromuscular blocking agents used in RSI.
• Elderly patients may have unique responses to these agents.

Purpose of the Study:

• To compare the efficacy of rocuronium versus suxamethonium for endotracheal intubation in patients aged 80 years and above.
• To evaluate intubating conditions, success rates, and adverse events associated with each agent during RSI.

Main Methods:

• A randomized controlled trial involving 90 patients (≥80 years old) undergoing RSI.
• Patients received either rocuronium 1.0 mg/kg or suxamethonium 1.0 mg/kg.
• Intubating conditions were assessed using the Fuchs-Buder scale 60 seconds post-administration; video laryngoscopy was used.

Main Results:

• Excellent intubating conditions were achieved in 73% of the rocuronium group and 75% of the suxamethonium group (p=0.82).
• First-pass success rates were high and similar (98%) in both groups.
• Suxamethonium demonstrated a significantly shorter onset time (131s vs 99s, p=0.01).

Conclusions:

• Rocuronium and suxamethonium yield comparable intubating conditions in elderly patients during RSI.
• No significant differences were noted in first-pass success, intubating difficulty, or postoperative side effects.
• Suxamethonium offers a faster onset of action compared to rocuronium in this patient population.