To compare the effect of Low Dose Atracurium versus Low Dose Rocuronium on quality of intubation in children undergoing adenotonsillectomies.

Abstract

Objectives: We conducted this study by comparing low dose of atracurium with low dose rocuronium to see their effects on quality of endotracheal intubation and recovery characteristics as these both agents are widely available and practiced in anesthesia. Study Design: This is prospective, randomised, double blind clinical trial. Setting: ENT operating room of King Khalid Hospital, Saudi Arabia. Period: From January 2018 to April 2018. Material & Methods: In this study, 80 elective paediatric patients planned for adenotonsillectomies operations were randomly selected. Anesthesia was induced by using fentanyl 2 mcg/kg, propofol 2 mg/kg. Patients were divided into two groups, group A and group R. Group A received 0.3 mg/kg atracurium and group R received 0.3 mg/kg rocuronium to facilitate endotracheal intubation. Sevoflurane was used for maintenance of anaesthesia in 50 percent oxygen and 50 percent nitrous oxide. Dexamethasone 0.1 mg/kg was administered in all patients to reduce post operative airway oedema and prophylaxis for PONV. Quality of intubation was assessed and graded as; Good: Jaw and vocal cords relaxed and no patient movement/coughing upon laryngoscopy/intubation. HR and BP within 20 percent range. Fair: Jaw and vocal cords relaxed but patient show body movement/coughing upon laryngoscopy/intubation HR and BP within 20 percent range. Poor: Jaw is partially relaxed, vocal cords moving/closed and patient shows body movement/coughing upon laryngoscopy/intubation. HR and BP beyond 20 percent range. Results: There were 40 patients in each group. 37.5 percent were operated for tonsillectomy, 32.6 percent for adenotonsillectomy and 30.1 percent for tonsillectomy and there was no statistically significant difference regarding type of operation (P=0.861). Age (P=0.321), sex (P=0.370) and weight (P=0.243) in both groups. Grades of intubation quality were comparable and same in both groups (P=0.710). Extubation and recovery was also normal and same in both groups. Conclusion: Low doses of atracurium or low dose of rocuronium can be safely used for good quality of endotracheal intubation and smooth recovery in elective paediatric patients coming for short ENT operations.