A prospective, randomized controlled study to compare the intubating conditions achieved with suxamethonium and rocuronium bromide

Background: Endotracheal intubation is required for giving general anesthesia for which adequate muscle relaxation is necessary. Suxamethonium is still used as a relaxant for endotracheal intubation Rocuronium, a nondepolarizing muscle relaxant was compared here for tracheal intubating conditions. Aim of the study: To compare the intubating conditions achieved in patients undergoing elective surgeries under General Anaesthesia with Suxamethonium or Rocuronium in 60 secs and complications in both groups. Materials and methods: This study was conducted in Institute of Anaesthesiology and Critical care at Madras medical college, Chennai during the period 2014 – 15100 patients of ASA I and II were divided randomly into 2 groups undergoing elective surgeries: Group I - Suxamethonium Group II - Rocuronium assessed for intubating conditions after administration of the corresponding drug. Results: The intubating conditions were excellent in group I Suxamethonium as against Group II Rocuronium in 60 secs. According to the cooper scoring system the scores of vocal cord movement in group I (Suxamethonium) was 2.68 (mean) ± 0.471 and in group II (Rocuronium) was 2.34±0.557, the scores of response to intubation in group I (Suxamethonium) was 2.98±0.141 and in group II (Rocuronium) was 2.70±0.463 with better intubating conditions in group I receiving Suxamethonium than Rocuronium. The results were significant with a p-value of<0.05 whereas the scores of jaw relaxation in group I patients (Suxamethonium) was 2.70 (mean)±0.463 and group II patients (Rocuronium) was 2.52±0.544 with better jaw relaxation. Conclusion: Rocuronium can be used as an alternative when suxamethonium is contraindicated for rapid intubation but not if the anticipated difficult airway is present. Rocuronium can be chosen as an alternative to it even in rapid sequence intubation in emergency cases, provided the airway is properly assessed and no anticipated difficult intubation is present.