Rocuronium continuous infusion versus intermittent bolus for maintaining suitable muscle relaxation and recovery status without using a peripheral nerve stimulator during anesthesia

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Introduction The objective of anesthesia has always been to enable correction of surgical pathology with the best technique and minimum risk to the patient. The aim of the present study was to determine clinically, without using a peripheral nerve stimulator, whether continuous infusion or intermittent bolus dosing of rocuronium bromide yielded a better clinical condition during general anesthesia. Patients and methods The study was carried out on 60 adult patients. A common technique of general anesthesia was used in all patients. Patients were randomized to receive either a continuous infusion (group I, n = 30) or intermittent bolus dosing (group II, n = 30) of rocuronium bromide. Intraoperatively (a), hemodynamic parameters (heart rate and arterial pressure), (b) clinical relaxation by a grading technique, (c) total drug requirement, (d) recovery status by modified Steward score were assessed and were compared between the two groups. Results The mean heart rate and mean arterial pressure at different time intervals after intubation with rocuronium were not significantly different between the two groups. The total drug requirement was significantly greater in patients who received an intermittent bolus dose of rocuronium than those who received a continuous infusion. Clinical relaxation and recovery status in patients receiving rocuronium infusion were significantly better. Conclusion Rocuronium infusion offers a better and stable degree of relaxation compared with intermittent bolus dosing for intermediate duration of operation, which can be assessed using the clinical relaxation grading system. Rocuronium is a rapidly acting and hemodynamically stable nondepolarizing muscle relaxant with fewer drug requirements and provides better quality of recovery status during a continuous infusion.