Comparison of rocuronium and suxamethonium for rapid tracheal intubation in children

Paediatr Anaesth. 2002 Feb;12(2):140-5. doi: 10.1046/j.1460-9592.2002.00771.x.


Background: The purpose of our study was to determine whether a smaller dose of rocuronium than previously reported could provide similar intubating conditions to suxamethonium during rapid-sequence induction of anaesthesia in children.

Methods: One hundred and twenty ASA I, unpremedicated children, aged 1-10 years, who were undergoing elective surgery, were randomized into three groups to receive rocuronium 0.6, rocuronium 0.9 or suxamethonium 1.5 The study was double-blinded, anaesthesia and timing of injection was standardized to alfentanil 10, thiopentone 5 and the study drug. Intubation was attempted at 30 s after injection of neuromuscular relaxant and intubating conditions graded as excellent, good, poor or impossible.

Results: All 120 children were successfully intubated within 60 s without need for a second attempt after administration of neuromuscular relaxant. Differences between suxamethonium and rocuronium 0.6 and between the two doses of rocuronium were statistically significant (P=0.016 and 0.007, respectively).

Conclusions: Rocuronium 0.9 provides similar intubating conditions to suxamethonium 1.5 during modified rapid-sequence induction using alfentanil and thiopentone in children (P=0.671). Rocuronium 0.6 was inadequate.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Alfentanil
  • Androstanols* / administration & dosage
  • Anesthesia*
  • Anesthetics, Intravenous
  • Child, Preschool
  • Double-Blind Method
  • Female
  • Humans
  • Intubation, Intratracheal*
  • Male
  • Neuromuscular Depolarizing Agents* / administration & dosage
  • Rocuronium
  • Succinylcholine* / administration & dosage
  • Thiopental
  • Time Factors


  • Androstanols
  • Anesthetics, Intravenous
  • Neuromuscular Depolarizing Agents
  • Alfentanil
  • Succinylcholine
  • Thiopental
  • Rocuronium