ROCURONIUM VERSUS CISATRACURIUM: INTUBATING CONDITIONS, EFFICACY, AND SAFETY.

Abstract

Background: Neuromuscular blockers (NMB) are very important adjuvant to general anesthesia,Rocuronium bromide (aminosteroidal NMB) and cisatracurium besylate (benzylisoquinoline NMB) are recently introduced non-depolarizing muscle relaxants.In a prospective randomized study,we had compared both the drugs as regard to the onset of action, intubating conditions,clinical duration,hemodynamic changes,and adverse effects. Method: 80 female patients ASA I&II,18-60 year old underwent elective abdominal surgery under general anesthesia (GA) were randomly assigned into 2 equal groups.ROC group,where 0.9mg/kg rocuronium was given and CIS group, where 0.15mg/kg cisatracurium was given. Standardized GA was given to all patients as follows, fentanyl 1mcg/kg, propofol 2mg/kg,intubation was tried by the same anesthetist who was blind to the given NMB after 60 sec of injection, intubation was done if the intubating condition was acceptable (excellent or good),and it was re-attempted every 30 sec if it was poor or inadequate.Anesthesia was maintained by 60% N2O in O2 and isoflurane to a total MAC 1.5,controlled ventilation was adjusted to normocapnia.Mean arterial blood pressure (MAP),heart rate,and intubating conditions were recorded. Results: Clinically acceptable intubating conditions were achieved after 60 sec more frequently with rocuronium (80%) than with cisatracurium(0%).Rocuronium had advantage of rapid onset of action with good intubating conditions as compared to Cisatracurium and both were found to be potent and safe with excellent cardiovascular stability and also without any apparent histamine release. Conclusion: Rocuronium has a rapid onset of action with good intubating conditions in comparison to cisatracurium both are potent and safe with excellent cardiovascular stability and do not cause apparent histamine release