Effects of Priming on Onset Time and Intubating Conditions With Rocuronium- A Prospective Randomised Comparative Study

Abstract

BACKGROUND Rocuronium is a newer non-depolarising muscle relaxant with faster onset of action than other non-depolarising muscle relaxants that could be an alternative to succinylcholine in rapid sequence intubation where succinylcholine is contraindicated. Based on onset of action, 0.9-1.2 mg/kg dose of rocuronium may be necessary as an alternative to succinylcholine at the cost of increased clinical duration. In this study, 0.6 mg/kg rocuronium with priming was compared against a single intubating dose of 0.9 mg/kg to know the influence of priming technique on the onset times and intubating conditions. MATERIALS AND METHODS A total of 60 patients were randomly allocated to two groups of 30 each. Group A (priming group) received 0.06 mg/kg of rocuronium as priming dose and 0.54 mg/kg rocuronium as intubating dose 3 minutes after priming. Group B (single intubating dose group) received a single intubating dose of 0.9 mg/kg. The onset time of intubation (loss of T1 of TOF stimulation) and intubating conditions were assessed. Continuous measurements were presented as mean±SD using 't' test and categorical measurements were presented as number (%). RESULTS Demographic data were comparable with respect to age, sex and weight. The onset time of intubation was 60±13.6 seconds in group A and 60±15.7 seconds in group B. Excellent to good intubation conditions were obtained in both groups. CONCLUSION Priming technique hastens the onset of action of rocuronium and with priming we can reduce the dose of rocuronium used for intubation thereby reducing the duration of action.