Rocuronium Versus Cis-Atracurium in Rapid Sequence Induction of Morbidly Obese Patients; Prospective Randomized Clinical Trial

Background: The use of larger doses of neuromuscular blockers may shorten the onset of intubation. Aim of Study: This study aimed to evaluate the use of triple the (ED95) of rocuronium or cis-atracurium on the timing and the score of intubation in morbidly obese patients. Patients and Methods: Sixty adult morbid obese patients were included in this study and allocated randomly according to the muscle relaxant used for induction of anesthesia into either ROC group; in which 0.9mg/kg of rocuronium was used or CIS group; in which 0.15mg/kg of cis-atracurium was used. The onset and the duration of relaxation, the time of intubation, the intubation score, and the incidence of compli-cation were measured. In addition, the changes in the hemo-dynamic parameters were recorded. Results: In comparison to cis-atracurium, the use of triple (ED95) of rocuronium in rapid sequence induction of anesthesia significantly shortened the onset of relaxation from 96.00±13.29 to 84.00±18.50sec (p=0.005, CI 3.675; 20.325), and the time of intubation from 104.55±17.91 to 89.14±20.43 sec (p=0.002, CI 6.00; 24.82). However, the duration of relaxation was significantly prolonged from 58.76±9.27 to 69.86±8.38min (p=0.003, CI 2.533; 11.667). Moreover, the intubation score was comparable between the two groups (p=0.994). Conclusion: The use of triple the (ED95) of rocuronium as compared to cis-atracurium in rapid sequence induction of anesthesia of morbidly obese patients significantly shortened the onset of relaxation and the time of inubation with an insignificant effect on the intubation score. Clinical trial registration: Pan African Clinical Trial Registry (PACTR201703002147145) (www.pactr.org).