Remifentanil versus rocuronium to improve video-laryngoscope intubation conditions
Remifentanil Versus Rocuronium for Optimizing Video Laryngoscopy-assisted Tracheal Intubation in Patients Undergoing General Anaesthesia - a Multicentre Randomised Controlled Trial -The ROCVIDEO Trial
PHASE4 · Nordsjaellands Hospital · NCT06564857
This trial will see if a large dose of remifentanil can replace rocuronium to make video-laryngoscope intubation easier and safer for adults having general anaesthesia.
Quick facts
| Phase | PHASE4 |
|---|---|
| Study type | Interventional |
| Enrollment | 2648 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Nordsjaellands Hospital (other) |
| Locations | 2 sites (Copenhagen and 1 other locations) |
| Trial ID | NCT06564857 on ClinicalTrials.gov |
What this trial studies
This is a Phase 4, randomized interventional comparison of remifentanil versus the neuromuscular blocker rocuronium during induction for orotracheal intubation using video laryngoscopy. Adult patients (ASA I–III) undergoing general anaesthesia who do not require rapid sequence induction are enrolled and randomized to receive either remifentanil-based induction or rocuronium before intubation. The trial will record intubation conditions, airway complications, and perioperative respiratory or neuromuscular adverse events. The study is conducted at North Zealand Hospital (Hillerød) and Rigshospitalet (Copenhagen) in Denmark with standard anesthesia monitoring and informed consent procedures.
Who should consider this trial
Good fit: Adults aged 18 or older scheduled for general anaesthesia with orotracheal intubation who are ASA class I–III and not indicated for rapid sequence induction are eligible.
Not a fit: Patients needing rapid sequence induction, those with neuromuscular disease or contraindications to remifentanil or rocuronium, pregnant or breastfeeding patients, or those having oral/pharyngeal/laryngeal surgery are unlikely to benefit from joining this trial.
Why it matters
Potential benefit: If successful, this could allow safe intubation without neuromuscular blockers, reducing the risk of residual paralysis, anaphylaxis, and some postoperative pulmonary complications.
How similar studies have performed: Previous studies have tested high-dose opioids as an alternative to neuromuscular blockers with mixed results, so this trial adds head-to-head comparative data rather than introducing a completely novel idea.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults ≥ 18 years * Undergoing general anaesthesia requiring oro-tracheal intubation * Absence of indication for rapid sequence induction * American Society of Anesthesiologists (ASA) physical status score I - III Exclusion Criteria: * Known allergies or contraindications to rocuronium (e.g. neuromuscular disease) or remifentanil * Awake intubation * Double-lumen endotracheal tube * Oral, pharyngeal, and laryngeal surgery * Surgical contraindication for NMBAs (e.g. use of nerve stimulator) * Patients who are pregnant or breastfeeding * Patients who do not understand Danish or are unable to give informed consent
Where this trial is running
Copenhagen and 1 other locations
- Department of Anesthesiology, NOH, Rigshospitalet — Copenhagen, Denmark (RECRUITING)
- Department of Anesthesiology, North Zeeland Hospital — Hillerød, Denmark (RECRUITING)
Study contacts
- Principal investigator: Anders K Nørskov, PhD — Department of Anaesthesia, Nordsjællands Hospital - Hillerød, Denmark
- Study coordinator: Anders K Nørskov, PhD
- Email: anders.kehlet.noerskov@regionh.dk
- Phone: 48292510
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Tracheal Intubation, Video Laryngoscopy, Remifentanil, Rocuronium