A Comparative Study to Evaluate the Effects of Priming on Intubating Time and Conditions with Rocuronium Bromide

Context: Succinylcholine cannot be used for rapid sequence induction or intubation (RSI) in several situations due to associated side effects. Rocuronium bromide has faster onset time among nondepolarizing muscle relaxants and can offer a safe alternative for RSI when the priming principle is used. Aims: This study was designed to compare the effects of rocuronium with different priming intervals on the time of intubation and intubating conditions. Setting and Design: This randomized, prospective double‑blind study was conducted in patients for abdominal and peripheral limb surgeries under general anesthesia at a tertiary care hospital. Materials and Methods: Ninety patients of American Society of Anesthesiologists (ASA) physical status I and II, aged 20‑50 years, of both sexes were divided into three groups of 30 each. Group A patients received a priming dose of 0.06 mg/kg of rocuronium followed by 0.54 mg/kg rocuronium 3 min later. Group B received 0.06 mg/kg followed by 0.54 mg/kg rocuronium 2 min later, and Group C received saline followed by 0.6 mg/kg rocuronium 3 min later. Time of intubation was assessed using train‑of‑four (TOF) stimuli, and intubating conditions were compared by the Cooper scoring system. Statistical Analysis: Analysis of variance (ANOVA) test was used to compare the time of intubation and intubating conditions among the groups. Results: The onset time of intubation was 57.4 ± 16.3 s in Group A, 104.8 ± 11.5 s in Group B, and 123.9 ± 13 s in group C. Intubating conditions were clinically acceptable in all three groups. Conclusion: The 3‑min priming interval of rocuronium provides excellent intubating conditions in less than 60 s and can be used in RSI.