Ch. Penchalaiah1, N. Jagadeesh Babu2, T. Kumar3
BACKGROUND AND OBJECTIVE: The goal of rapid sequence intubation is to secure the patients airway smoothly and quickly, minimizing the chances of regurgitation and aspiration of gastric contents. Traditionally succinylcholine chloride has been the neuromuscular blocking drug of choice for use in rapid sequence intubation because of its rapid onset of action and profound relaxation. Succinylcholine chloride remains unsurpassed in providing ideal intubating conditions. However the use of succinylcholine chloride is associated with many side effects like muscle pain, bradycardia, hyperkalaemia and rise in intragastric and intraocular pressure. Rocuronium bromide is the only drug currently available which has the rapidity of onset of action like succinylcholine chloride. Hence the present study was undertaken to compare rocuronium bromide with succinylcholine chloride for use during rapid sequence intubation in adult patients.
METHODOLOGY: The study population consisted of 90 patients aged between 18-60 years posted for various elective surgeries requiring general anaesthesia. Study population was randomly divided into 3 groups with 30 patients in each sub group. 1. Group I: Intubated with 1 mg kg-1 of succinylcholine chloride (n=30). 2. Group II: Intubated with rocuronium bromide 0.6 mg kg-1 (n=30). 3. Group III: Intubated with rocuronium bromide 0.9 mg kg-1 (n=30). Intubating conditions were assessed at 60 seconds based on the scale adopted by Toni Magorian et al. 1993. The haemodynamic parameters in the present study were compared using p-value obtained from student t-test.
RESULTS: It was noted that succinylcholine chloride 1 mg kg-1 body weight produced excellent intubating conditions in all patients. Rocuronium bromide 0.6 mg kg-1 body weight produced excellent intubating conditions in 53.33% of patients but produced good to excellent intubating conditions in 96.67% of patients. Rocuronium bromide 0.9 mg kg-1 body weight produced excellent intubating conditions in 96.67% of patients, which was comparable to that of succinylcholine chloride. Thus increasing the dose of rocuronium bromide increased the number of excellent intubating conditions but at the cost of increased duration of action.
INTERPETATION AND CONCLUSION: Thus, from the present study, it is clear that succinylcholine chloride is the drug of choice for rapid sequence intubation. Rocuronium bromide is a safe alternative to succinylcholine chloride in conditions where succinylcholine chloride is contraindicated and in whom there is no anticipated difficult airway.
