Cisatracurium versus rocuronium in tracheal intubation for general anesthesia / 第二军医大学学报

ABSTRACT

Objective: To compare the efficiencies of cisatracurium and rocuronium during tracheal intubation for general anesthesia. Methods: Sixty ASA I-II patients undergoing elective surgery were randomly divided into 3 groups in which patients received a single bolus of rocuronium 0.6 mg/kg (A group, n = 20), cisatracurium 0.1 mg/kg (B group, n = 20), or 0.15 mg/kg (C group, n = 20). Anesthesia was induced with midazolam, etomidate, and fentanyl. Neuromuscular function was assessed using accelerography with TOF. First twitch (T 1) was used as the study parameter. Patients received a rapid bolus administration of study drugs within 10 seconds after T1 became stable at 100%; meanwhile, mask oxygen inhalation was offered for 2 min and then intubation was carried out. The systolic pressure, diastolic pressure, and heart rate were recorded at baseline level, before and 1,2,3,4,5,10, and 15 min after intubation. The intubation conditions were assessed. Whether intubation could be carried out successfully or not and T1 25% recovery time after the initial bolus were also recorded. The adverse effects and respiratory complication during operation and after operation were observed. Results: The hemodynamic changes within 15 min after intubation were not significantly different compared with those before induction in 3 groups (P>0.05). Maximal neuromuscular block rates in group A,B, and C were (99.4±2.7)%, (99.1±1.9)%, and (99.9±0.3)%, respectively, with no significant differences found between the three groups (P>0.05); the onset time periods of the 3 groups were (1.9±1.1) min, (3.6±2.1) min, and (3.3±1.5) min, respectively, with that of group A significantly shorter than those of B and C groups (P0.05). The glottis exposure degree in group A was significantly better than that of B and C groups (P0.05). Conclusion: Rocuronium is superior to cisatracurium in induction intubating for general anesthesia in terms of clinical effect time and glottis exposure degree, and it can provide better intubating conditions.