| A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients. | |
| | |
MedLine Citation:
|
PMID: 11099426 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To compare rocuronium and succinylcholine for rapid-sequence intubation (RSI) in the emergency department (ED). METHODS: A one-year prospective cohort comparison study was performed using a data collection form completed at the time of intubation. Data collected included the reason for the neuromuscular-blocking agent (NMBA) chosen, the time to onset of paralysis, and any complications encountered. Three ten-point numerical descriptor scales recorded the degree of body movement, vocal cord movement, and the physician's overall satisfaction with the extent of paralysis. RESULTS: Succinylcholine was used in 382 patients and rocuronium was used in 138 (26% of all RSI) patients. The mean (+/- SD) times of onset of succinylcholine and rocuronium were 39 +/- 13 sec and 44 +/- 20 sec, respectively (p = 0.04). No patient desaturated and required assisted ventilations while waiting for paralysis to occur. Types of body movements were similar with the two agents, but less frequent with succinylcholine (median = 10, mean = 9.5 +/- 1.1) than rocuronium (median = 10, mean = 9.1 +/- 1. 5) (p = 0.01). Vocal cord movements were similar for succinylcholine (median = 10, mean = 9.2 +/- 1.6) and rocuronium (median = 9, mean = 9.0 +/- 1.6) (p = 0.15). The physician's overall satisfaction with the extent of paralysis was also higher for succinylcholine (median = 10, mean = 9.4 +/- 1.3) than rocuronium (median = 10, mean = 8.8 +/- 2.0) (p < 0.01). Only one complication, widening of the QRS complex secondary to succinylcholine use in a patient with unsuspected hyperkalemia, could be attributed to the choice of NMBA. CONCLUSIONS: Both succinylcholine and rocuronium produced fast and reliable paralysis for RSI. Although succinylcholine had a faster onset and provided more relaxation, the difference had no clinical significance. Approximately a fourth of ED RSI patients qualified for use of rocuronium using these high-risk criteria. |
| | |
Authors:
|
E G Laurin; J C Sakles; E A Panacek; A A Rantapaa; J Redd |
Related Documents
:
|
8540456 - Natural history, determinants, and clinical relevance of conduction abnormalities follo... 15904926 - A histological study of the cardiac conduction system in a heifer with complete atriove... 125036 - Right ventricular volume in congenital heart disease. 7238556 - Clinicopathologic assessment of arrhythmias in a case of scleroderma heart disease with... 20303806 - A prospective evaluation of cerebral infarction following transcervical carotid stentin... 10150996 - Echocardiography in the management of single ventricle: fetal through adult life. |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Volume: 7 ISSN: 1069-6563 ISO Abbreviation: Acad Emerg Med Publication Date: 2000 Dec |
Date Detail:
|
Created Date: 2001-01-25 Completed Date: 2001-01-26 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 9418450 Medline TA: Acad Emerg Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1362-9 Citation Subset: IM |
Affiliation:
|
Division of Emergency Medicine, University of California, Davis, Medical Center, University of California, Davis, School of Medicine, Sacramento, CA, USA. eglaurin@ucdavis.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Androstanols
/
therapeutic use* Emergency Service, Hospital Female Humans Intubation, Intratracheal* Male Neuromuscular Depolarizing Agents / therapeutic use* Neuromuscular Nondepolarizing Agents / therapeutic use* Prospective Studies Statistics, Nonparametric Succinylcholine / therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
0/Androstanols; 0/Neuromuscular Depolarizing Agents; 0/Neuromuscular Nondepolarizing Agents; 143558-00-3/rocuronium; 306-40-1/Succinylcholine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Critical care in the emergency department: A physiologic assessment and outcome evaluation.
Next Document: Comparison of intravenous midazolam with pentobarbital for sedation for head computed tomography ima...