Could rapacuronium and rocuronium be a valid alternative to succinylcholine for rapid sequence induction of anesthesia in adults?

ABSTRACT

The intubating conditions provided by rapacuronium [Org 9487], rocuronium and succinylcholine after rapid sequence induction of anesthesia in adults undergoing surgery [elective or emergency] were assessed in this study. A total of 100 ASA I or II studied patients was randomly allocated to one of three treatment groups according to the muscle relaxant used [rapacuronium, rocuronium and succinylcholine]. Both rapacuronium and rocuronium groups were divided into two subgroups according to the dose used to rapacuronium [2 and 2.5 mg/kg] and rocuronium [0.6 and 1 mg/kg]. All patients received the same induction agents [fentanyl 1-2 ug/kg and propofol 1.5-2 mg/kg]. Fentanyl was injected intravenously four minutes before propofol injection, followed by a period of three-minute preoxygenation. The study concluded that 60 seconds after the administration of rapacuronium [2 or 2.5 mg/kg] or rocuronium [1 mg/kg], clinically acceptable intubating conditions were achieved as frequent as after succinylcholine during rapid sequence induction of anesthesia in adults given fentanyl and propofol as induction agents