Document Detail


Rocuronium vs. succinylcholine in the emergency department: a critical appraisal.
MedLine Citation:
PMID:  19097730     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Two methods of paralysis are available for rapid sequence intubation (RSI) in the emergency department (ED): depolarizing agents such as succinylcholine, and non-depolarizing drugs such as rocuronium. Rocuronium is a useful alternative when succinylcholine is contraindicated. Contraindications to succinylcholine include allergy, history of malignant hyperthermia, denervation syndromes, and patients who are 24-48 h post burn or crush injury. Non-depolarizing drugs have the advantage of causing less pain due to post-paralysis myalgias.
CLINICAL QUESTION: Can rocuronium replace succinylcholine as the paralytic of choice for RSI in the ED? EVIDENCE REVIEW: Four relevant studies were selected from an evidence search and a structured review performed.
RESULTS: For the outcomes of clinically acceptable intubation conditions and time to onset, the two agents were not statistically significantly different. Succinylcholine seems to produce conditions that have higher satisfaction scores.
CONCLUSION: Succinylcholine remains the drug of choice for ED RSI unless there is a contraindication to its usage.
Authors:
William K Mallon; Samuel M Keim; Jan M Shoenberger; Ron M Walls
Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article; Review     Date:  2008-12-20
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  37     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-03     Completed Date:  2009-10-26     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-8     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Los Angeles County/University of Southern California Medical Center, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Androstanols / pharmacology,  therapeutic use*
Child
Evidence-Based Medicine
Female
Humans
Intubation, Intratracheal / methods*
Male
Neuromuscular Blocking Agents / pharmacology,  therapeutic use*
Neuromuscular Depolarizing Agents / pharmacology,  therapeutic use*
Neuromuscular Nondepolarizing Agents / pharmacology,  therapeutic use*
Succinylcholine / pharmacology,  therapeutic use*
Time Factors
Chemical
Reg. No./Substance:
0/Androstanols; 0/Neuromuscular Blocking Agents; 0/Neuromuscular Depolarizing Agents; 0/Neuromuscular Nondepolarizing Agents; 143558-00-3/rocuronium; 306-40-1/Succinylcholine
Comments/Corrections
Comment In:
J Emerg Med. 2010 Sep;39(3):345-6; author reply 346-7   [PMID:  20456897 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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