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Innovative Medicines & Omics Rocuronium versus succinylcholine in general anesthesia

received 1.5 mg/kg of succinylcholine and 1.2 mg/kg of to examine the onset, ease of intubation, and hemodynamic
rocuronium, maintaining normal airways. The study parameters of succinylcholine and rocuronium during
found no discernible difference between acceptable and general anesthesia. Intubating conditions were evaluated
good intubating settings, concluding that succinylcholine using criteria established by Cooper. Two equal groups
and rocuronium provided comparable intubation success were randomly selected from the study population.
within 60 s. The onset times for both drugs were in the In Group 1, 94% of patients achieved clinically
range of 56.50 ±1.20 s, consistent with findings from acceptable intubating conditions, while in Group 2, 98%
Mazurek et al., Naguib et al., and Magorian et al. 3 (including 88% with excellent conditions) did so. The
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For the RSI of anesthesia in adult patients, Magorian et al. mean onset of action was 56.42 ± 1.14 s for Group 1
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examined rocuronium, succinylcholine, and vecuronium. and 56.36 ± 1.08 s for Group 2. One minute after
A total of 55 patients participated in the study and were intubation, both groups experienced significant increases
randomized to receive one of three intravenous doses of in HR, SBP, DBP, and MAP. These alterations, which
succinylcholine (1 mg/kg), vecuronium (0.1 mg/kg), or were hemodynamically comparable between the two
rocuronium (0.6, 0.9, and 1.2 mg/kg). Midazolam and medications, however, normalized within 5 min. It can be
fentanyl were administered as premedication, followed by concluded from the study that intubation can be done 60 s
2.7 mg/kg of thiopental for anesthesia induction. Intubation after a bolus dose of rocuronium (1.2 mg/kg) under good
attempts were made after 60 s. Patients receiving 0.9 mg/kg to excellent circumstances. Succinylcholine demonstrated
and 1.2 mg/kg of succinylcholine and rocuronium had better intubating conditions, while rocuronium may serve
similar onset times. The longest clinical duration of action, as a good substitute, particularly for patients at risk of
however, was observed with rocuronium at 1.2 mg/kg. The succinylcholine-related side effects.
investigation noted a dose-dependent reduction in the
onset of rocuronium. Even though the two higher dosages of Acknowledgments
rocuronium had similar onset times, their clinical duration We sincerely thank the management of Maharishi
was significantly longer than that of succinylcholine. Markandeshwar University, Ambala, Haryana, India, for
Furthermore, there were no significant changes observed providing the necessary facilities to conduct this study. We
in the hemodynamic variables – HR, SBP, DBP, MAP, or also express our gratitude to the Department of Anesthesia,
SpO – in either group. SBP, DBP, and MAP did, however, Maharishi Markandeshwar Super Specialty Hospital,
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slightly increase 1 min after each group was inducted. The Ambala, Haryana, India, for encouraging and supporting
study was consistent with the findings reported by Neil us during the research work. In addition, we extend our
et al. The Lovina Neil-led research team compared 60 thanks to all the patients who provided their consent to
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ASA I and II patients aged 20 – 60 who had undergone participate in this study.
a variety of surgical events. The patients were separated
into two groups, each consisting of 30 patients. Patients Funding
in Group II received intravenous rocuronium bromide at None.
a dose of 0.9 mg/kg, while patients in Group I received
1.5 mg/kg of succinylcholine chloride. Patients were pre- Conflict of interest
medicated with glycopyrrolate (4 µg/kg intravenous) and
fentanyl (2 µg/kg intravenous), followed by induction The authors declare no conflicts of interest.
with thiopentone (3 – 7 mg/kg intravenous) until the loss Author contributions
of eyelash reflex. Muscle relaxation was administered for
60 s before intubation. The results demonstrated that 96.7% Conceptualization: Aditya Sharma
and 86.7% of the patients in Groups I and II, respectively, Formal Analysis: Aditya Sharma
achieved good intubating conditions. Investigation: Hanan Shakeel
Methodology: Vikrant Abbot
5. Conclusion Writing – original draft: Hanan Shakeel
In the practice of general anesthesia, endotracheal Writing – review & editing: Vikrant Abbot
intubation is crucial. The ease of this procedure depends Ethics approval and consent to participate
on the anesthesiologist’s skill, the depth of anesthesia,
and the degree of muscle relaxation. This study compared This study was approved by the ethical committee
two neuromuscular drugs, such as succinylcholine and of Mullana Multispecialty Hospital, Ambala. Before
rocuronium, used for endotracheal intubation. The study conducting the study, written consent was taken from all
was prospective, randomized, single-blind, and controlled the patients involved in the study.

Volume 1 Issue 1 (2024) 112 doi: 10.36922/imo.3196