Online) An Open Access

Hassan, Ahmed, Syed Manzar, Hassan, Sameer Ahmed
2016 International Journal of Basic and Applied Medical Sciences   unpublished
Neuromuscular blocking agents are an integral part of balanced general anaesthesia and they have been routinely used in anaesthesia practice. The present study presents the onset of action of succinylcholine and rocuronium bromide (ORG 9426) for optimal intubating conditions. The study reveals that rocuronium is a good muscle relaxant and can be used as an alternative to succinylcholine. INTRODUCTION Booij et al., (1988) published the first abstract on rocuronium at Ninth world congress of
more » ... thesiologists at Washington. Since then many abstracts and publication on rocuronium have followed. Muir et al., (1989) studied the effects of ORG 9426 in anaesthetized cats and pigs and in isolated neuromuscular preparations. They concluded that ORG 9426 was 20% as potent as vecuronium, onset of action was twice rapid and duration of action of two drugs was similar. Wierda et al., (1990) clinically observed that ORG 9426 was 6-8 times less potent than vecuronium and showed a faster rate of development of neuromuscular blockade with good to excellent intubating conditions within 60 seconds after administration of 0.5 mg/kg. The duration of action and recovery index appeared to be similar to that of vecuronium. Side effects were not noted. O' Kelly et al., (1992) studied the time course of 0-8 mg/kg rocuronium in children (1.5-7.5 yrs.) under N2O-halothane anaesthesia. Following this dose, a rapid onset time of 28 seconds was found while clinical duration and recovery index were 32.3 and 8.6 minutes respectively. No significant changes in haemodynamic parameter were observed. Wierda et al., (1991) also studied the pharmacodynamic and kinetics of ORG 9426 in great detail at university of Groningen, The Netherlands and published their study in Canadian Journal of Anaesthesia. Pubringer and Pearson et al., (1992) evaluated the endotracheal intubating conditions of rocuronium and succinylcholine in outpatient surgery. They concluded that inspite of pharmacodynamic difference between two, intubating conditions after administration of both compounds, are similar and develop at the same rate. Huizinga et al., (1992) studied the intubating conditions and onset of neuromuscular block of rocuronium and also compared it with succinylcholine. Rocuronium produced good to excellent intubating conditions at 60 seconds as well as at 90 seconds after administration, even though there was only a partial blockade of adductor pollicis muscle. Cooper and Crawford et al., (1992) compared intubating conditions after administration of ORG 9426 and succinylcholine. They found that clinically acceptable intubating conditions were attained in 95% of patients at 60 second and in all patients at 90 seconds who received rocuronium. Clinically acceptable conditions were attained in all patients on both times after succinylcholine. All patients were premedicated with oral temazapam and anaesthesia was induced with thiopentone and fentanyl. Prior administration of succinylcholine did not appear to influence the potency of ORG 9426. Woelfel et al., (1992) studied the effect of bolus administration of intubating dose of 0.6 mg/kg of ORG 9426 in children during N2O-Halothane anaesthesia. The onset time of 90% and 100% neuromuscular block was 0.8 and 1.3 min respectively. A clinical duration around 25 minutes was seen. Only a minimal transient rise in heart rate was observed. The