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Intubation conditions after rocuronium or succinylcholine for rapid sequence induction with alfentanil and propofol in the emergency patient - 29/9/2005


Eur J Anaesthesiol 2005; 22: 748-53

Introduction


It has previously been recommended that doses of 0.9-1.2 mg/kg rocuronium are used in elective patients to obtain comparable intubation conditions with succinylcholine 1.0 mg/kg after 60 seconds during a rapid-sequence induction. The present authors carried out a study to compare the overall intubating conditions of standard doses of rocuronium 0.6 mg/kg and succinylcholine 1.0 mg/kg during a strict rapid-sequence induction regimen including propofol and alfentanil.


Methods


Patients scheduled for emergency abdominal or gynaecological surgery and with increased risk of pulmonary aspiration of gastric contents were randomized to a rapid-sequence induction with succinylcholine 1.0 mg/kg or rocuronium 0.6 mg/kg. Patients with a predicted difficult airway were excluded. A senior anaesthesiologist ‘blinded’ for the randomisation performed the intubation 60 seconds after injection of the neuromuscular blocker. Intubating conditions were evaluated according to an established guideline. Tracheal intubation not completed within 30 seconds was recorded as failed.

Results


A total of 222 patients were randomised. Clinically acceptable intubation conditions were present in 93.5% and 96.1% of patients in the succinylcholine group (n=107) and the rocuronium group (n=102), respectively (p=0.59).

Conclusions


The results showed that during a rapid-sequence induction with alfentanil and propofol, both rocuronium 0.6 mg/kg and succinylcholine 1.0 mg/kg provide clinically acceptable intubation conditions in 60 seconds in patients scheduled for emergency surgery. The authors conclude that, under the conditions of this rapid-sequence induction regimen, rocuronium may be a substitute for succinylcholine.


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ArticleDate:20050929
SiteSection: Abstracts



 
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