Abstract

Neuromuscular-blocking drugs prevent neuromuscular transmission at the neuromuscular junction, resulting in skeletal muscle paralysis. It is accomplished by their activity on the post-synaptic acetylcholine (Nm) receptors. The neuromuscular block is clinically used adjunctively to anesthesia to produce paralysis, paralyze the vocal cords, permit intubation of the trachea, and optimize the surgical field by inhibiting spontaneous ventilation and causing relaxation of skeletal muscles. Rocuronium bromide is the new steroidal non-depolarizing neuromuscular blocking agent shown to have rapid onset of action. It has the fastest onset as compared to all other available non depolarizing neuromuscular blockers, with an onset time similar to succinylcholine. Materials and Methods: This is a Prospective randomized study was conducted in the Department of Anesthesiology at Yashoda Hospital from February 2022 to January 2023. Over a period of 6 months among 90 patients were divided into three groups of 30 each. After 3 minutes of preoxygenation, the patient was induced with Inj. Propofol 2 to 2.5 mg / kg over 15 seconds. The H.R. and B.P. were measured. Depending on the Group, a bolus i.v. dosage of Inj. Rocuronium 0.6mg/kg (2 ED95), Inj. Rocuronium 0.9mg/kg (3 ED95), or Inj. Rocuronium 1.2mg/kg (4 ED95) was administered in 5 seconds. peripheral nerve stimulator was used to stimulate the ulnar nerve in the wrist. The current strength was gradually raised, and a single twitch was evoked. When the maximum amount of thumb adduction was accomplished, the current strength was recorded, and one and a half times the strength was utilized to elicit the Train of Four Stimulus. Results: In our study, there is a significant difference among the three groups on mean onset time (p<0.05), but there is no significant difference between the Group 2 (0.9 mg/kg) and group 3 (1.2mg/kg). There is no significant difference among the three groups on duration of blockade, and there is a significant difference between group 2 (0.9 mg/kg) and group 3 (1.2 mg/kg) with p-value (p<0.05). There is significant difference among the groups (0.6 mg/kg, 0.9 mg/kg, 1.2 mg/kg) on systolic blood pressure after intubation, at 1 minute and 3 minutes. There is no significance among the groups at 5 minutes. There is no significance between group 2(0.9 mg/kg) and group 3 (1.2 mg/kg). Conclusion: This study showed a significant difference of onset of action of rocuronium across various intubating conditions (73.6 seconds with 0.6mg/kg, 66.6 secpnds with 0.9mg/kg and 45 seconds with 1.2mg/kg). There is no statistical significant in change in duration of action of rocuronium across the various dosage observed. There is significant difference of intubating scores observed between group 1(0.6mg/kg) and group 2 (0.9mg/kg), group 1 (0.6mg/kg) and group 3 (1.2mg/kg) with no difference between group 2 and group 3. There is significant difference of blood pressure (systolic, dialstolic and mean) change observed across three groups but no change in heart rate.

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