Rocuronium Is Not Associated with More Vocal Cord Injuries than Succinylcholine After Rapid-Sequence Induction: A Randomized, Prospective, Controlled Trial
- 1 March 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 102 (3), 943-949
- https://doi.org/10.1213/01.ane.0000194509.03916.02
Abstract
Postoperative hoarseness (PH), sore throat (ST), and vocal cord injuries (VCI) are common complications after general anesthesia. Excellent endotracheal intubating conditions are associated with less laryngeal morbidity than good or poor intubating conditions. Thus, we tested the hypothesis that a rapid-sequence induction (RSI) with succinylcholine would lead to less PH and VCI than with rocuronium. In this prospective trial, 160 patients were randomized in 2 groups to receive thiopental 5.0 mg/kg, fentanyl 3.0 microg/kg, succinylcholine 1.0 mg/kg, or rocuronium 0.6 mg/kg during RSI. PH and ST were assessed at 24, 48, and 72 h after surgery, VCI were examined by stroboscopy in those patients who had PH >3 days. Excellent and clinically acceptable intubating conditions were significantly increased in the succinylcholine group compared with the rocuronium group: 57% versus 21% and 89% versus 59%, respectively (P < 0.001). The incidence and severity of PH, and VCI between the succinylcholine and the rocuronium groups did not differ significantly: PH: 50% versus 51% (P = 0.99) and VCI: 3% versus 1% (P = 0.98), respectively. Similar findings were found for ST, 39% versus 28% (P = 0.22), and postoperative myalgia, 39% versus 29% (P = 0.25), respectively. Intubating conditions were significantly better in the succinylcholine group compared with the rocuronium group. The incidence and severity of ST and myalgia were not increased in the patients receiving succinylcholine. However, the rate of PH and VCI was similar to the rocuronium group.This publication has 23 references indexed in Scilit:
- Laryngeal Morbidity and Quality of Tracheal IntubationAnesthesiology, 2003
- Postoperative sore throat after ambulatory surgeryBritish Journal of Anaesthesia, 2002
- Diagnosis and consequences of gastropharyngeal refluxClinical Otolaryngology, 2000
- Complications following the use of the Combitube, tracheal tube and laryngeal mask airwayAnaesthesia, 1999
- Postoperative sore throat: cause, prevention and treatmentAnaesthesia, 1999
- Postoperative throat complaints after tracheal intubationBritish Journal of Anaesthesia, 1994
- Hoarseness after tracheal intubationAnaesthesia, 1992
- Laryngeal trauma vs length of intubationThe Journal of Laryngology & Otology, 1987
- Correlation of Endotracheal Tube Size with Sore Throat and Hoarseness Following General AnesthesiaAnesthesiology, 1987
- Voice changes after thyroidectomy: role of the external laryngeal nerve.BMJ, 1984