HAEMODYNAMIC EFFECTS AND INTUBATING CONDITIONS FOLLOWING ROCURONIUM AND ITS COMBINATION WITH VECURONIUM OR PANCURONIUM IN ELECTIVE PAEDIATRIC CARDIAC PATIENTS

Rapid airway control and cardiovascular stability are the prime objectives of anaesthetic induction for patients undergoing open heart surgery. Among all the drugs used for a smooth induction, muscle relaxants played a pivotal role. In the present study we compared the intubating conditions and haemodynamics following rocuronium alone, and a mixture of rocuronium with either vecuronium or pancuronium. Forty-five children of acynotic congenital heart disease, between age range of 3 months to 12 years were randomly allocated to three groups after induction with halothane in N2O-O-2. Group R (n=15) received rocuronium 900 square gkg(-1), group RV (n=15) received mixture of rocuronium 500 square gkg(-1) and vecuronium 50 square gkg(-1) and group RP (n=15) received rocuronium 500 square gkg(-1) mixed with pancuronium 50 square gkg(-1). Intubation was attempted 60 seconds after injection of relaxant by the anaesthetist blinded to the type of relaxant and intubating conditions were evaluated. Heart rate and mean blood pressure were recorded before and after induction, after administration of relaxant and at one, two, three and five minutes after intubation. Intubating conditions were acceptable (good and excellent) in 100% patients in group R, 93.3% in group RV and 86.7% in group RP. There was significant increase in heart rate after administration of relaxant in group R and RP even before intubation was attempted. There was significant increase in heart rate and mean arterial pressure after intubation in all the groups. To conclude, the mixture of rocuronium with vecuronium not only provided acceptable intubating condition and haemodynamic stability but also emerged out to be an economic alternative while compared with rocuronium alone.