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British Journal of Anaesthesia, 2000, Vol. 85, No. 2 246-250
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

Onset/offset characteristics and intubating conditions of rapacuronium: a comparison with rocuronium

T. J. Zhou, P. F. White, J. W. Chiu, G. P. Joshi, K. K. Dullye, L. L. Duffy and W. K. Tongier

Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75235, USA*Corresponding author

We compared onset and offset of action and tracheal intubating conditions after rapacuronium and rocuronium in 60 patients in a randomized, assessor-blinded study. Following induction of anaesthesia with propofol 2.5 mg kg–1, either rapacuronium 1.5 mg kg–1 (n=30) or rocuronium 0.6 mg kg–1 (n=30) was administered to facilitate tracheal intubation. Anaesthesia was maintained with either a propofol infusion (100 µg kg–1 min–1) or sevoflurane (1% end-tidal) with 66% nitrous oxide (N2O), n=15 in each subgroup. Neuromuscular monitoring was performed using an electromyographic (EMG) device (Datex Relaxograph). The lag times (mean 42 (SD 11) s and 44 (16) s), maximum block (99 (2)% and 98 (3)%) and intubating conditions at 60 s (good-to-excellent in 86% and 84% of patients) were similar for rapacuronium and rocuronium, respectively. The onset time of rapacuronium was shorter than rocuronium (87 (20) vs 141 (65) s, P<0.001), and the degree of block at 60 s was greater (69 (26) vs 50 (27)%, P<0.05). Twenty-five per cent recovery was shorter with rapacuronium than rocuronium during propofol (15.0 (3.2) vs 39.1 (14.2) min, P<0.001) and sevoflurane (15.1 (4.2) vs 47.8 (19.0) min, P<0.001) anaesthesia. We conclude that rapacuronium 1.5 mg kg–1 had a more rapid onset, similar intubating conditions, and shorter recovery times than rocuronium 0.6 mg kg–1.

Br J Anaesth 2000; 85: 246–50


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