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ISSN 2063-5346
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A Randomized, Comparative Study of Intubating Conditions and Duration of Action of Three Different Doses of Rocuronium Bromide 0.6, 0.9 And 1.2 Mg/Kg Body Weight

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Dr Soumya Mysore Venugopal, Dr Manasa Deepti Vaka, Dr V.B Gowda, Dr. Asha Harave Linganna
» doi: 10.48047/ecb/2023.12.7.345

Abstract

Rocuronium is a monoquaternary amino steroid nondepolarizing neuromuscular blocking drug with rapid onset, intermediate duration of action and widely used when succinylcholine is considered undesirable or contraindicated for rapid sequence intubation. The current study aims to compare three multiples of ED95 doses of rocuronium 2xED95(0.6mg/kg), 3x ED95(0.9 mg/kg) and 4x ED95 (1.2mg/kg) in terms of their intubating conditions at the end of 60 sec and their duration of action in patients undergoing elective surgeries under general anaesthesia. Methodology: After our Hospital Research and Ethics Committee approval and obtaining informed written consent, 90 ASA physical status I or II patients scheduled for elective surgeries under general anesthesia were included in this prospective, randomized, comparative study. The patients were randomly assigned into three groups of 30 patients each, to receive one of the three doses 0.6 mg/kg, 0.9 mg/kg or 1.2 mg/kg of rocuronium. Intubation was performed 60 sec later and intubating conditions were assessed using coopers scoring system including the parameters jaw relaxation, vocal cord condition and response to intubation. In addition vocal cord position and movement of limbs during intubation were also assessed. Continuous TOF monitoring is initiated after induction and the time to recovery of 25% of first twitch of TOF is determined to be the duration of action of the induction dose of rocuronium. Patients were monitored throughout the procedure for any adverse effects. Results: The three groups had similar demographics in terms of age, gender, weight, ASA grade and MMP grade .The intubating conditions in group A ( 0.6 mg/kg) were excellent in 63.3%,good in 30 %, unacceptable in 6.7 %.The intubating conditions in group B ( 0.9 mg/kg) were excellent in 86.7%,good in 13.3 %.The intubating conditions in group C (1.2mg/kg) were excellent in 93.3 % and good in 6.7 %.Jaw Relaxation was similar in group B ( 90 % excellent, 10 % good ) and C ( 93.3% excellent ,6.7% good ) with no statistically significant difference. Group A showed 63.3 % excellent, 33.3%good and 3.3% fair relaxation .Vocal cord position observed was similar in Group B and C with 93.3% in abducted position and 6.7% in intermediate position .In Group A cords were in intermediate position in 13.3% and abducted in the rest. Movement of limbs : 90 % in group A had no movement where as 10 % showed slight movement of limbs. In group B, 93.3% had no movement and 6.7 % had slight movement. Group C showed no movement of limbs. Group B and Group C showed no significant difference with respect to vocal cord position and movement of limbs. These finding correlated as well with findings of coopers criteria. There is no statistically significant difference observed with respect to movement of limbs among group A and B as well. The duration of action determined in the study was Group A : 32.97±4.57 min,Group B : 45.27±8.57 min,Group C : 63.27±7.01 min Conclusion: Rocuronium 0.9 mg/ kg and 1.2 mg/kg provided acceptable intubating conditions at the end of 60 sec in all cases.Duration of action increases significantly as the dose increases .1.2 mg/kg achieved best intubating conditions compared to 0.6 mg/kg and 0.9 mg/kg .Increasing the dose of rocuronium to 1.2 mg/kg did not produce any adverse effects

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