Comparison of Onset of Action, Intubating Conditions, and Recovery Characteristics of Rocuronium and Cisatracurium In Patients Undergoing Abdominal Surgery under General Anesthesia: A Prospective Randomized Control Trial

Swati Taneja; Amardeep Kaur; Shalvi Mahajan; Ankit Kansal

doi:10.18502/aacc.v9i5.13954

Swati Taneja Department of Anesthesia, and Critical Care, VMMC and Safdarjung hospital, New Delhi, India.
Amardeep Kaur Department of Anesthesia, and Critical Care, Fortis hospital, Mohali, India.
Shalvi Mahajan Department of Anesthesia, and critical care, PGIMER, Chandigarh, India.
Ankit Kansal Department of Anesthesia, and critical care, ESIC hospital, Ludhiana, India.

DOI: https://doi.org/10.18502/aacc.v9i5.13954

Keywords: Rocuronium; Cisatracurium; Endotracheal intubation; Neuromuscular blocking drugs; Train of four count

Abstract

Background: Neuromuscular blocking drugs (NMBD) have paved the way for the conduct of every known surgical procedure. However, the hunt for optimum NMD with appropriate intubating circumstances is continuous. Rocuronium and cisatracurium are amongst the newer NMBDs. We aim to compare the onset of action, intubating conditions, duration of action, and recovery features in a dose twice the ED95 in patients having abdominal surgery.

Methods: A total 60 American Society of Anesthesiology (ASA) I and II adult patients were randomized equally into Group A and Group B. Group A received Inj. Rocuronium 0.6 mg/kg and Group B received Inj. Cisatracurium 0.10 mg/kg. We assessed the intubating conditions after ensuring jaw relaxation using both the clinical criteria and neuromuscular monitoring whereas onset time, duration of action and recovery time were assessed using neuromuscular monitoring only.

Results: In Group A, a significant rapid onset of action of muscle relaxant was seen compared to Group B (2.4±0.30 mins versus 4.0±0.09 mins, p= 0.00). 93% patients had excellent intubating conditions in Group A compared to 73% patients in Group B (p= 0.038). The duration of action in Group A was 36.73±1.05 mins and in Group B was 47.40 ±1.33mins (p=0.00). Similarly, early mean duration of recovery was found in Group A-45.30±1.29mins versus Group B -57.77±1.19 mins, p= 0.00).

Conclusion: Rocuronium provides rapid onset of action with excellent intubating conditions, and shorter duration of action with an early recovery time compared to cisatracurium.