Rocuronium versus cisatracurium in pediatric day case surgery: Hemodynamics and intubation criteria

Objectives: This prospective, randomized, double-blind study was designed to compare the pharmacodynamic parameters and intubation criteria of cisatracurium and rocuronium induced neuromuscular blockade in children following a single dose of 2 x ED95 of both drugs allowing spontaneous complete recovery in cases scheduled for elective day case surgery at Mansoura Children's University Hospital. Methods: Forty children, ASA I-II, aged (2-10) years subjected for elective day case surgery at mansoura children's university hospital were enrolled in this study. The patients were randomly classified using closed envelops method, into 2 groups, each one consisted of 20 patients according to the type of muscle relaxant used: Rocruronium group: intubation was induced with rocuronium 600 μg/kg and maintained with rocuronium 150 μg/kg per dose. Cisatracurium group: intubation was induced with cisatracurium 100 μg/kg and maintained cisatracurium 25μg/kg per dose. Parameters recorded included: onset time, duration of action, recovery index and intubating conditions of two studied drugs. Hemodynamic variables (heart rate and mean arterial pressure) and oxygen saturation were recorded. postoperative complications were also recorded. Results: The onset time, duration of action and recovery index for rocuronium (Group R) were shorter than those for cisatracurium (Group C), showing a highly significant inter group differences (P < 0.001). Conclusion: We concluded that both relaxants showed good to excellent intubating criteria 90 sec after induction of muscle paralysis, rocuronium showed better criteria than cisatracurium which developed significant slight cough, bucking and movements after tracheal intubation. However rocuronium has faster onset, shorter duration of action and faster recovery time than cisatracurium.