Prehospital tracheal intubating conditions during rapid sequence intubation: Rocuronium versus vecuronium

• Published in: Air medical journal Vol. 21; no. 1; pp. 26 - 32
• Main Authors: Smith, Charles E., Kovach, Betty, Polk, James D., Hagen, Joan F., Fallon, William F.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2002
• Subjects: Adult; Androstanols - administration & dosage; Androstanols - pharmacology; Emergency Medical Services; Female; Health administration; Hemodynamics - drug effects; Humans; Intubation, Intratracheal; Laryngoscopy; Male; Middle Aged; Neuromuscular Nondepolarizing Agents - administration & dosage; Neuromuscular Nondepolarizing Agents - pharmacology; Ohio; Prospective Studies; Transportation of Patients; Vecuronium Bromide - administration & dosage; Vecuronium Bromide - pharmacology; Ohio
• ISSN: 1067-991X; 1532-6497
• DOI: 10.1067/mmj.2002.121713

Introduction: The study purpose was to evaluate tracheal intubating conditions and cardiovascular effects of rocuronium and vecuronium (vec) in the transport setting.
Methods: A prospective blinded study of adult patients requiring emergency rapid sequence oral tracheal intubation using direct laryngoscopy. Patients received equipotent doses of roc 1.0 mg/kg (n=44) or vec 0.15 mg/kg (n=56) on an alternate day basis.
Results: Intubation was successful in 95% of patients in the vec group and 100% in the roc group. The percentage of patients having good or excellent jaw relaxation and vocal cord exposure was similar between groups (vec/79%, roc/77%). Eleven patients (vec/7, roc/4) had difficult intubation as evidenced by Grade III or IV view and more than three attempts. Five patients in the vec group had inadequate neuromuscular blockade versus 1 patient in the roc group (
P=0.17). No cardiovascular differences occurred between groups after intubation.
Conclusion: Tracheal intubating conditions and clinical evidence of complete neuromuscular blockade tended to be better after roc than after vec.