Comparative Analysis of Atracurium and Rocuronium in General Anesthesia: Distribution and Effects on Vital Signs

Background: The Muscle relaxants are necessary in anesthesia management that used to facilitate the intubation and for ensure muscle relaxation during surgery. The Rocuronium and Atracurium are two most commonly used non-depolarizing muscle for relaxants of muscles, which each have novel effects on hemodynamic parameters, since they are major for maintaining stability during surgical procedures. Objective: The present study aims to compare the hemodynamic effects of both Rocuronium and Atracurium during surgery apparatus in adult patients that undergoing general anesthesia, their effect on systolic blood pressure and diastolic blood pressure, mean arterial pressure (MAP), heart rate, and oxygen saturation (SpO2). Materials and Methods: A randomized clinical trial was conducted at Baghdad Teaching Hospital and Al-Kindi Hospital from February to May 2021. Eighty adult patients (ASA I or II) were randomly assigned to receive either Rocuronium (0.6~mg/kg) or Atracurium (0.5~mg/kg) after induction with intravenous propofol (1.5–2.5~mg/kg) and ketamine (0.5~mg/kg). Hemodynamic parameters were monitored pre-induction, at induction, and at intervals of 1-, 3-, 5-, and 10-minutes post-induction using CETUS x15, PHILIPS, and COMeN monitors. Results: Atracurium administration showed significant effects on DBP and SBP during intraoperative monitoring, with notable changes in pulse rate, SpO2, and MAP over time. In contrast, Rocuronium exhibited minimal impact on these hemodynamic parameters during the intraoperative period, except for slight variations in SBP and MAP at the 20- and 30-minute marks. Conclusion: The findings indicate that Atracurium affects hemodynamic stability more than Rocuronium, particularly influencing DBP, SBP, and pulse rate. These results suggest that age and gender considerations, along with patient-specific hemodynamic responses, are essential in selecting appropriate muscle relaxants during general anesthesia. Further research is warranted to understand the underlying mechanisms contributing to these differences.