Rocuronium versus succinylcholine for rapid sequence intubation in patients with bowel obstruction

Abstract

Introduction. The aim of the study was to determine intubation conditions in the patients receiving rocuronium in compari-son to succinylcholine for rapid sequence intubation during the induction of anes-thesia for operative management of bowel obstruction. Methods. In the randomized controlled study 30 adult patients with bowel obstruc-tion undergoing urgent surgery were ran-domly allocated in two groups. For muscle relaxation the S-group of patients received succinylcholine (1.5 mg/kg) and the R-group rocuronium (1.2 mg/kg). Intubation conditions were evaluated using a grad-ing system according to Viby-Morgenson. Primary outcomes were intubation con-ditions 1 minute after the application of a muscle relaxant. Secondary outcome measures were heart rate, blood pressure, and pulse oximetry; potassium and myo-globin serum level.Results. All patients were orotracheally intubated in the first attempt. During in-duction, we didn’t observe vomiting or as-piration. Overall intubation conditions in the S-group were statistically significantly better than in the R-group. After RSI there was a statistically significant decrease in systolic and diastolic blood pressure in both groups and statistically significant decrease in heart rate in the S-group. After RSI the potassium level in the S-group was significantly higher in comparison to the R-group and serum myoglobin level non-significantly increased in the S-group and statistically significantly decreased in the R-group.Conclusion. The results show that rocuronium in RSI patients with bowel obstruc-tion enables the same intubation condi-tions as succinylcholine and the same risk of aspiration which allows succinylcholine replacement and avoidance of its side ef-fects.