[Rocuronium, the "ideal" nondepolarizing muscle relaxant?]

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Succinylcholine is the preferred agent for rapid sequence intubation.
• Current non-depolarizing agents like vecuronium and atracurium have a slower onset of action, typically requiring 3 minutes for intubation.
• There is a need for a non-depolarizing muscle relaxant with a faster onset to replace succinylcholine.

Purpose of the Study:

• To review available information on rocuronium bromide (Org 9426), a new steroidal muscle relaxant.
• To summarize the efficacy of rocuronium bromide for rapid tracheal intubation.

Main Methods:

• Review of current clinical trial data and published studies on rocuronium bromide.
• Comparison of rocuronium bromide's onset of action and intubating conditions with existing muscle relaxants, including succinylcholine, vecuronium, and atracurium.

Main Results:

• Rocuronium bromide provides rapid intubating conditions within 30 to 90 seconds after a 0.6 mg/kg dose.
• Intubating conditions achieved with rocuronium bromide are comparable to those achieved with succinylcholine.
• While the onset at peripheral muscles is slower than succinylcholine, rocuronium bromide allows for faster intubation than other non-depolarizing agents.

Conclusions:

• Rocuronium bromide is a promising new non-depolarizing muscle relaxant with a rapid onset of action.
• It offers rapid development of excellent intubating conditions, potentially allowing for faster tracheal intubation.
• Rocuronium bromide may serve as a viable alternative to succinylcholine for rapid sequence intubation.