Surgical conditions with rocuronium versus suxamethonium in cesarean section: a randomized trial
Language English Country Netherlands Media print-electronic
Document type Comparative Study, Journal Article, Randomized Controlled Trial
PubMed
31537420
DOI
10.1016/j.ijoa.2019.08.005
PII: S0959-289X(19)30528-X
Knihovny.cz E-resources
- Keywords
- Cesarean section, Muscle relaxation, Neuromuscular block, Operative time, Surgical conditions,
- MeSH
- Time Factors MeSH
- Cesarean Section * MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Humans MeSH
- Prospective Studies MeSH
- Rocuronium pharmacology MeSH
- Succinylcholine pharmacology MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
- Names of Substances
- Rocuronium MeSH
- Succinylcholine MeSH
BACKGROUND: Onset times and conditions for intubation after rocuronium versus suxamethonium at cesarean section have been evaluated, but no study thus far has examined the influence of these neuromuscular blocking drugs on the surgical conditions or their effect on the duration of surgery and the ease of fetal delivery. We aimed to compare the surgical conditions for delivery in parturients who received deep neuromuscular block with rocuronium with those who had induction with suxamethonium. METHODS: Ninety patients undergoing cesarean section under general anesthesia were randomized to receive either rocuronium 0.6 mg/kg or suxamethonium 1 mg/kg for tracheal intubation and delivery. Times to delivery and the quality of surgical conditions, using a five-point Surgical Rating Scale for Delivery (SRSD) ranging from 1 (poor) to 5 (excellent), were evaluated. RESULTS: The median SRSD (range) was found to be significantly better in the rocuronium group [4 (3-5) points vs 3 (2-4) points with suxamethonium (P <0.001)]. Whereas the mean (SD) induction-to-intubation interval was longer with rocuronium [106 (34) s vs 68 (32) s with suxamethonium (95% CI of the difference 24 to 52 s, P <0.001)], the incision-to-delivery interval was shorter in the rocuronium group [147 (68) s vs 196 (51) s with suxamethonium (95% CI of the difference -75 to -24 s, P <0.001)]. The mean induction-to-delivery intervals were similar [268 (73) s vs 276 (63) s, respectively]. CONCLUSIONS: Whereas the induction-to-delivery intervals were comparable, we found rocuronium superior to suxamethonium in allowing better surgical conditions for fetal delivery, which enabled an easier delivery and a shorter incision-to-delivery interval.
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