Rocuronium 0.3 mg/kg or 0.9 mg/kg comparing onset time, duration of action and intubating conditions in patients 80 years and older. A randomized study

• Published in: Acta anaesthesiologica Scandinavica
• Main Authors: Vested, Matias, Pape, Pernille, Kristensen, Camilla Meno, Dinesen, Felicia, Vang, Malene, Christensen, Rasmus Ejlersgård, Bjerring Lindahl, Cecilie, Albrechtsen, Charlotte, Rasmussen, Lars S
• Format: Journal Article
• Language: English
• Published: England 08.06.2022
• ISSN: 1399-6576

Limited data exist about the optimal dose of rocuronium for intubation in elderly patients. We hypothesized that rocuronium 0.9 mg kg would lead to a shorter onset time than 0.3 mg kg in patients above 80 years. Thirty-four patients were randomized to either rocuronium 0.3 mg kg or 0.9 mg kg . The primary outcome was onset time defined as time to train-of-four (TOF) count of 0. Other outcomes included duration of action (time to TOF ratio > 0.9), proportion of excellent intubating conditions using the Fuchs-Buder scale and tracheal intubating conditions using the Intubating Difficulty Scale (IDS). Rocuronium 0.9 mg kg resulted in shorter onset time compared to rocuronium 0.3 mg kg ; 108 sec (SD 40) vs. 228 sec (SD 140) (difference: 119 seconds (95% CI: 41-196), P=0.005)), respectively. However, in 66% of the patients receiving rocuronium 0.3 mg kg a TOF count of 0 was not obtained. Duration of action was longer after rocuronium 0.9 mg kg : 118 minutes (SD 43) vs. 46 minutes (SD 13) (difference: 72 minutes (95% CI: 49-95) P<0.0001)), and a greater proportion of excellent intubating conditions (Fuchs-Buder) was obtained; 11/16 (69%) vs 4/18 (22%) (P=0.006). No difference was found regarding IDS score. Rocuronium 0.9 mg kg resulted in a shorter onset time compared to rocuronium 0.3 mg kg in patients above 80 years of age. In 66% of the patients receiving rocuronium 0.3 mg kg a TOF count of 0 was not obtained.