Rocuronium versus succinylcholine for rapid sequence induction of anesthesia in elective cesarean section

ABSTRACT

This study was conducted on forty parturient women undergoing elective cesarean section under general anesthesia to evaluate the onset and tracheal intubation condition together with the fetal and maternal impacts of rocuronium and succinylcholine for rapid sequence induction. The parturient women were randomly allocated into two groups [20 women each] according to the neuromuscular blocker used, group A [0.6mg/kg rocuronium] and group B [Img/kg succinylcholine]. After pre-oxygenation, rapid sequence induction was performed with thiopental sodium 4-6mg/kg followed by either rocuronium or succinylcholine according to the group. Neuromuscular transmittion was assessed using electromyographic response to train of four stimulation of the ulnar nerve at the wrist every 10 seconds. The time to the beginning of depression of Tl amplitude [lag time] and the time to maximum depression of Tl [onset time] were compared in the two groups. They were [25.2 +/- 2.7], [71.7 +/- 2.7] seconds for group [A] and [22.4+2.2], [50.6 +/- 8.2] seconds for group [B] respectively. There were statistically significant difference between the two groups as regard lag time and onset time [P<0.05, P<0.01 respectively] As regard, the. intubation conditions, there was no statistically significant difference between the two groups. There is statistically significant difference as regard maternal heart rate or mean blood pressure between the two groups [P<0.01, P<0.05 respectively]. As regard Apgar score, there was no statistically significant difference between the groups. It can be concluded that rocuronium provide good intubating conditions comparable to those of succinylcholine and is suitable for rapid sequence intubation when succinylcholine is contraindicated. It is also safe for both the mother and the foetus. List of abbreviations NMB Neuromuscular blocker EMG Electromyography MMG Mechanomyography