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Comparison of remifentanil and rocuronium for improving video laryngoscopy assisted tracheal intubation in adult patients undergoing general anesthesia

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What is this trial about?

A plain-language summary of the goals, design and what participants do

This clinical study compares two medications used during general anesthesia when placing a breathing tube into the windpipe using a special camera device called video laryngoscopy. The two medications being studied are remifentanil, a strong pain medication, and rocuronium, a muscle relaxant. Both medications are given through a vein as an injection.

The purpose of this research is to determine which medication provides better and safer conditions for placing the breathing tube in adult patients who need tracheal intubation during surgery. The study will look at how well each medication works and any possible side effects that may occur during or after the procedure.

During the study, patients will receive either remifentanil or rocuronium before the breathing tube is inserted. Doctors will monitor patients for any complications that might occur within 24 hours after the procedure, including effects on breathing, heart function, or discomfort in the throat. The medication doses are carefully calculated based on each patient's weight, with remifentanil given at up to 4 micrograms per kilogram and rocuronium at up to 0.6 milligrams per kilogram.

The research process

The trial runs in 5 steps – from screening to follow-up. Each step says what happens and what the team monitors.

  1. Step 1

    Initial assessment and preparation

    Your eligibility for the study will be confirmed based on the following criteria: you must be at least 18 years old, scheduled for general anesthesia requiring a breathing tube, and have an ASA physical status score between I and III (indicating your overall health condition).

    The procedure will be performed using a special camera device called a video laryngoscope to help place the breathing tube.

  2. Step 2

    Medication assignment

    You will be randomly assigned to receive one of two medications through an intravenous injection:

    Option 1: Remifentanil (a pain medication)

    Option 2: Rocuronium (a muscle relaxant)

  3. Step 3

    Anesthesia procedure

    The assigned medication will be administered through an intravenous line (a small tube in your vein)

    A breathing tube will be placed using the video laryngoscope

    Your vital signs and condition will be continuously monitored during the procedure

  4. Step 4

    Monitoring period

    You will be monitored for any immediate effects during the first 20 minutes after the procedure

    Continued observation will occur for up to 24 hours after the procedure to check for any delayed effects

  5. Step 5

    Assessment of outcomes

    The medical team will evaluate the success of the tube placement on the first attempt

    Any effects you experience will be documented, including throat discomfort, breathing changes, or other reactions

    Your participation in the study will end after the 24-hour monitoring period

Who can join the trial?

6 criteria

  • Must be at least 18 years old
  • Must be scheduled for general anesthesia that requires placement of a breathing tube through the mouth into the windpipe
  • Must not require rapid sequence induction (a special fast technique for placing breathing tubes in emergency situations)
  • Must have an ASA physical status score between I and III (this is a scale used by anesthesiologists to assess a patient's overall health before surgery: I means healthy, II means mild systemic disease, III means severe systemic disease)
  • Can be either male or female
  • Must be having a procedure where a video laryngoscope (a device with a camera used to help place breathing tubes) will be used

Who cannot join the trial?

15 criteria

  • Known allergy or hypersensitivity (severe adverse reaction) to remifentanil, rocuronium, or similar medications
  • Pregnant or breastfeeding women
  • Patients with severe liver disease (conditions affecting liver function)
  • Patients with severe kidney disease (conditions affecting kidney function)
  • History of difficult airway (previous problems with breathing tube placement)
  • Patients with neuromuscular disorders (conditions affecting muscle and nerve function)
  • Emergency or urgent surgeries requiring immediate intubation
  • Patients taking medications that could interact with study drugs
  • Participation in another clinical trial within the past 30 days
  • Inability to provide informed consent
  • Patients under 18 years of age
  • Patients with severe cardiovascular disease (heart and blood vessel conditions)
  • Known or suspected drug abuse
  • Patients with increased pressure inside the skull
  • Patients with severe breathing problems
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Investigated drugs

Remifentanil is a fast-acting opioid pain medication used during surgery. It helps to reduce pain and make intubation (inserting a breathing tube) more comfortable for patients during general anesthesia. The medication's effects wear off quickly after stopping its administration. Rocuronium is a muscle relaxant medication used during surgery to temporarily paralyze the muscles. It helps doctors insert breathing tubes more easily by relaxing the muscles in the throat and airways. The medication's effects can be reversed when needed using specific antidote medications. Both medications are being compared in this trial to determine which one provides better conditions for inserting breathing tubes using a video laryngoscope (a device with a camera used to guide tube placement) during general anesthesia.

What is already known about the treatment

  • Remifentanil

    A fast-acting opioid analgesic administered intravenously during anesthesia procedures, particularly for tracheal intubation. This medication works by binding to mu-opioid receptors in the central nervous system, providing rapid pain relief and sedation with an extremely short duration of action. It belongs to the class of synthetic opioid analgesics and is valued in anesthesiology for its precise controllability and quick elimination from the body.

  • Rocuronium

    A neuromuscular blocking agent administered intravenously to facilitate tracheal intubation during general anesthesia. This medication works by competitively blocking acetylcholine receptors at the neuromuscular junction, causing temporary muscle relaxation that aids in the intubation process. It belongs to the non-depolarizing neuromuscular blocker class and is widely used in modern anesthesia practice due to its intermediate duration of action and reliable onset time.

Investigated diseases

  • Respiratory Failure

    A condition where the respiratory system fails in one or both of its gas exchange functions: oxygenation and carbon dioxide elimination. The condition can develop gradually or suddenly, making it difficult for a person to breathe normally. It occurs when the lungs cannot get enough oxygen into the blood or remove enough carbon dioxide from it. The condition can be acute (developing quickly) or chronic (developing over time).

  • Airway Trauma

    An injury to the throat, windpipe, or breathing passages that can occur during medical procedures or accidents. It can affect any part of the upper or lower airway system. The condition can cause breathing difficulties and discomfort. Symptoms may include voice changes, difficulty swallowing, or breathing problems.

  • Pulmonary Aspiration

    A condition where food, drink, or stomach contents enter the airways instead of going into the esophagus and stomach. This occurs when the normal protective mechanisms of the body fail. The condition can cause inflammation in the lungs and breathing difficulties. It commonly occurs when someone is unconscious or has impaired reflexes.

  • Bradycardia

    A heart condition where the heart beats slower than normal, typically fewer than 60 beats per minute. The slow heart rate may cause insufficient blood flow to the body. Some people with bradycardia may experience fatigue, dizziness, or shortness of breath. The condition can range from mild to severe.

  • Pneumonia

    An infection that inflames the air sacs in one or both lungs. The air sacs may fill with fluid or pus, causing cough, fever, and difficulty breathing. The infection can be caused by various germs, including bacteria, viruses, and fungi. The severity can range from mild to severe.

Trial detailsLast updated 2 Oct 2026
Age18+ yearsPhasePhase ITrial ID2025-521405-40-01Estimated enrolment3 184 patientsSponsorNordsjaellands Hospital

sourced from the EU Clinical Trials Register and site verification

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On this site, “treatment” means an investigational medicine being studied in a clinical trial. Its safety and efficacy for the use being studied have not yet been confirmed, some participants may receive a placebo or a comparator medicine, and taking part does not guarantee any health benefit. The decision to take part is made by the doctor at the research site. This site is for information only and does not replace medical advice.

This service is not affiliated with the European Commission, the EMA, or the official CTIS system. Most information comes from publicly available international clinical-trial registries, supplemented by data from academic sites, national regulators and commercial sponsors. On this site, “treatment” and “therapy” mean a medicine being tested in a clinical trial. Its safety and effectiveness in the use being studied are not yet confirmed, some participants may receive a placebo or a comparator, and taking part does not guarantee a health benefit. The doctor at the research site decides who can take part. This site provides information, not medical advice. Certain content and visual elements on this website have been generated or enhanced using artificial intelligence (AI).