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Quality of Laryngoscopic View and Rapidity of Development of Intubating Conditions after Atracurium, Vecuronium and Rocuronium: A Randomized Controlled Study

Manasij Mitra, Abhishek Nag, Tanmoy Ganguly, Sandeep Kumar Kar and Santi Lahiri

Introduction: The choice of muscle relaxant for endotracheal intubation may be straightforward in selective cases, but in most patients, who are otherwise uncomplicated, poses a dilemma among anesthesiologists and intensivists. The authors examined the most commonly used muscle relaxants (Vecuronium, atracurium and rocuronium) in equipotent doses and compared the most vital parameters, i.e., rapidity of development of clinically acceptable intubating condition and quality of laryngoscopic view. Method: 150 adult patients of 18 to 50 y of age were recruited randomly into 3 equal groups having 50 patients (n=50) in each and equipotent dose of vecuronium, atracurium and rocuronium was administered. Endotracheal intubations were attempted every 30 seconds till excellent or good intubating conditions were achieved upto a maximum of 240 s. The available data were analyzed statistically.
Results: The three study groups were comparable in terms of the demographic characteristics. The quality of intubating condition was rated significantly better with Rocuronium than with Vecuronium and Atracurium. Time required to achieve successful intubation was also significantly less with rocuronium than with Vecuronium (107.48 ± 1.98*6.583 s vs. 165.46 ± 1.98*6.790 s) and Atracurium (107.48 ± 1.98*6.583 s vs. 195.43 ± 1.98*6.583 s). Excellent laryngoscopic condition was found in more patients with rocuronium at 60 and 90 s and number of successful intubation was also higher.
Conclusion: Therefore, the study confirms that rocuronium produces clinically acceptable intubating condition earlier than the other two drugs and the quality of intubating condition is better in terms of laryngoscopic view.