Comparison of rocuronium bromide and succinylcholine chloride for use during rapid sequence intubation in adult patients

Abstract

The introduction of endotracheal intubation during First World War and introduction of balanced anaesthesia in 1926, urged the search for a drug which could cause Jaw relaxation to facilitate endotracheal intubation.Succinylcholine chloride introduced in 1951, was a synthetic depolarising muscle relaxant. It fulfilled both of the above requirements and soon became the drug of choice for endotracheal intubation especially in rapid sequence intubation in emergency cases. Because of its adverse effects like hyperkalemia, rise in intragastric, intraocular, intracranial pressures and cardiovascular effects, a quest began for a safer substitute for Succinylcholine chloride. The new non depolarising muscle relaxant drug rocuronium bromide introduced in 1994 became the first competitor for Succinylcholine chloride. Rocuronium bromide when given in two to three times the ED95 dose is said to produce excellent to good intubating conditions in 60 seconds. Further rocuronium bromide is said to be devoid of the adverse effects that are seen with Succinylcholine chloride. Hence the present study was undertaken to evaluate the intubating conditions with rocuronium bromide 1 mg/kg body weight and to compare the intubating conditions with that of Succinylcholine chloride 1.5 mg/kg body weight, for use during rapid sequence intubation in adult patients. Rocuronium bromide 1 mg/kg body weight produces excellent intubating conditions in 96.67% of patients and good to excellent intubating conditions in 100% of patients at 60 seonds with an average clinical duration of action of 49 minute and 10 seonds.