A Randomised trial to compare the onset time and intubating conditions using Rocuronium with or without priming in adult patients.

Muscle relaxants are used during intubation and surgery to reduce the need for anesthesia and facilitate intubation.

Due to its rapid onset, short duration of action and profound muscle relaxation, succinylcholine (Depolarizing Muscle Relaxant) is used for rapid sequence induction and endotracheal intubation.

But, succinylcholine has a number of undesirable side-effects like muscle fasciculations, myalgia, hyperkalemia, bradyarrhythmia, increased intra-ocular, intracranial and intragastric pressure, malignant hyperthermia and masseter spasm.Due to these undesirable side-effects especially in patients having neuromuscular disorders, burns, acute head injury, open eye injury, spinal cord injury, cerebrovascular accidents and renal diseases, succinylcholine is not suitable.

Newer techniques using NDMR (Non-Depolarizing Muscle Relaxants) have evolved for rapid and smooth induction. Rocuronium is an NDMR. It produces faster neuromuscular blockade compared to other neuromuscular blocking drugs. It produces comparable intubating conditions to that of succinylcholine. When rocuronium is used with priming technique, it can be considered as an alternate to succinylcholine.

In priming principle, a divided dose technique of neuromuscular blocking drug is given which is capable of producing a rapid onset of neuromuscular block and suitable intubating conditions. A small priming dose(10% of NDMR)which will not cause any unpleasant side effects is used. It occupies 75% of end plate receptors. After 2–4 min, the rest of the intubating dose of the drug is administered to produce suitable conditions for endotracheal intubation.

This study is planned to evaluate and compare the effect of priming principle using rocuronium bromide on onset time of intubation and intubating conditions (using TOF monitoring).

This study is based on the hypothesis that priming with rocuronium may fasten the onset time compared to rocuronium without priming for endotracheal intubation.