Pharmacodynamics of rocuronium with and without prior administration of succinylcholine

J Clin Anesth. 1995 Feb;7(1):44-8. doi: 10.1016/0952-8180(94)00002-l.

Abstract

Study objectives: To compare succinylcholine (S) and rocuronium (R) used for endotracheal intubation, and to assess the possible action of S on subsequently administered R.

Design: Double-blind, randomized, phase III study.

Setting: University Medical Center.

Patients: 24 ASA physical status I and II patients, ages 28 to 65, undergoing general anesthesia for abdominal procedures.

Intervention: Double-blind administration of R 600 mcg/kg (Group A) or S 1 mg/kg was achieved with open label R 150 mcg/kg. Standardized general anesthetic technique with sodium thiopental, fentanyl, and nitrous oxide in oxygen was administered.

Measurements and main results: Neuromuscular junction was tested by ulnar nerve stimulation and mechanomyograph. Intubation was attempted at 80% first twitch depression of train-of-four. Heart rate and blood pressure were recorded throughout. Onset times were 74 +/- 37 seconds for S and 130 +/- 46 seconds for R. Intubation times were 76 +/- 29 seconds for S and 85 +/- 23 seconds for R (no significant difference). Good to excellent intubation conditions were achieved in both groups. S given prior to R decreased onset time and increased duration of R, when compared with R given alone. No drug related cardiovascular events were noted.

Conclusion: Rapid intubation conditions can be obtained after both S and R. Given its overall safety profile, R can be used when S is contraindicated, or in healthy patients with no apparent difficult airway, when procedures are expected to last more than 25 minutes.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase III
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Androstanols / pharmacology*
  • Anesthesia, Inhalation
  • Anesthesia, Intravenous
  • Blood Pressure / drug effects
  • Double-Blind Method
  • Drug Interactions
  • Female
  • Heart Rate / drug effects
  • Humans
  • Intubation, Intratracheal*
  • Male
  • Middle Aged
  • Neuromuscular Junction / drug effects
  • Neuromuscular Nondepolarizing Agents / pharmacology*
  • Rocuronium
  • Succinylcholine / pharmacology*
  • Time Factors
  • Ulnar Nerve / drug effects

Substances

  • Androstanols
  • Neuromuscular Nondepolarizing Agents
  • Succinylcholine
  • Rocuronium