High dose rocuronium or cisatracurium is a reliable alternative to succinylcholine for rapid sequence intubation

ABSTRACT

Endotracheal intubation conditions after 60 seconds following intravenous administration of succinylcholine [1 mg/kg, n=20], rocuronium [1.2 mg/kg, n=20], cisatracurium [0.15 mg/kg, n=20], or cisatracurium [0.2 mg/kg, n=20] were evaluated and compared. No significant differences were found between the doses of the three drugs. Intubation conditions were characterized as excellent or good in 90% of patients received cisatracurium 0.15 mg/kg and in 95% of patients received succinylcholine 1 mg/kg, rocuronium 1.2 mg/kg or cisatracurium 0.2 mg/kg. High dose rocuronium 1.2 mg/kg, cisatracurium [0.15-0.2 mg/kg], provides satisfactory intubation conditions after 60 seconds and can be used safely instead of succinylcholine for rapid-sequence intubation when a long duration of neuromuscular blockade is acceptable. High dose rocuronium superior to high dose cisatracurium, if rapid onset is concerned, however cisatracurium has a shorter duration of action