• Charles E Smith, Betty Kovach, James D Polk, Joan F Hagen, and William F Fallon.
• MetroHealth Medical Center, Department of Anesthesiology, Cleveland, OH 44109, USA. csmith@metro-health.org
• Air Med. J. 2002 Jan 1;21(1):26-32.

IntroductionThe study purpose was to evaluate tracheal intubating conditions and cardiovascular effects of rocuronium (roc) and vecuronium (vec) in the transport setting.MethodsA prospective blinded study of adult patients requiring emergency rapid sequence oral tracheal intubation using direct laryngoscopy. Patients received equipotent doses of roc 1.0 mg/kg (n = 44) or vec 0.15 mg/kg (n = 56) on an alternate day basis.ResultsIntubation was successful in 95% of patients in the vec group and 100% in the roc group. The percentage of patients having good or excellent jaw relaxation and vocal cord exposure was similar between groups (vec/79%, roc/77%). Eleven patients (vec/7, roc/4) had difficult intubation as evidenced by Grade III or IV view and more than three attempts. Five patients in the vec group had inadequate neuromuscular blockade versus 1 patient in the roc group (P = 0.17). No cardiovascular differences occurred between groups after intubation.ConclusionTracheal intubating conditions and clinical evidence of complete neuromuscular blockade tended to be better after roc than after vec.

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