Rocuronium versus succinylcholine: Are they equally effective during rapid-sequence induction of anesthesia?

Aleksandra J. Mazurek*, Bronwyn Rae, Susan Harm, J. Ike Kirn, Barbara Castro, Charles J. Coté

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

110 Scopus citations


The purpose of our study was to assess the onset and quality of muscle paralysis and intubation conditions with succinylcholine (Sch) or rocuronium (Roc) during rapid-sequence induction. Patients were randomly assigned to receive thiopental (5 mg/kg) and Sch (1.5 mg/kg) or thiopental (5 mg/kg) and Roc (1.2 mg/kg). The anesthesiologists performing the endotracheal intubation were blinded by standing with their back to the patient. Thirty seconds after drug administration, laryngoscopy was performed. Intubating conditions were scored, the clinical onset of apnea was noted, and a train-of-four monitor recorded data. All patients were ASA physical status I-III and scheduled for emergency procedures; both groups were demographically similar. Thirteen patients received Roc and 13 received Sch. There was no significant difference between the two groups in the number of patients receiving excellent intubating scores (P = 0.41) or in the combined number of patients receiving good and excellent scores (P = 1.0). There was no significant difference in time of onset of apnea for Sch (22 ± 13 s) versus Roc (16 ± 8 s). The return of the first twitch response was significantly faster with Sch (5.05 ± 2.5 min) compared with Roc (17.3 ± 21.7 min) (P = 0.0001). Implications: In pediatric patients scheduled for emergency surgery, thiopental 5 mg/kg and rocuronium 112 mg/kg provided conditions for the completion of intubation in <60 s comparable to those provided by thiopental 5 mg/kg and succinylcholine 1.5 mg/kg. We conclude that rocuronium is a reasonable substitute for succinylcholine in children for rapid-sequence intubation when a rapid return to spontaneous respiration is not desired.

Original languageEnglish (US)
Pages (from-to)1259-1262
Number of pages4
JournalAnesthesia and analgesia
Issue number6
StatePublished - Dec 1998

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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