Impact of Rocuronium and Succinylcholine on Sedation Initiation After Rapid Sequence Intubation

The Journal of Emergency Medicine
Eric G JohnsonStephanie Baker Justice

Abstract

Rapid sequence intubation (RSI) involves a rapidly acting sedative plus a neuromuscular blocking agent (NMBA) to facilitate endotracheal intubation. Rocuronium and succinylcholine are NMBAs commonly used in RSI with drastically different durations of action. Evaluate whether patients receiving RSI with a longer-acting NMBA had a greater delay in sedation or analgesia than patients that received a short-acting NMBA. This was a retrospective review of patients presenting to the emergency department requiring endotracheal intubation. Exclusions included age < 18 years, pregnancy, prior intubation, and contraindication to sedation and analgesia. Primary endpoint was time to continuous sedation or analgesia after RSI in patients receiving rocuronium or succinylcholine. Secondary endpoints included hospital length of stay (HLOS), intensive care unit length of stay (ICU LOS), and impact of an emergency medicine pharmacist (EPh). A total 106 patients met inclusion criteria, 76 patients receiving rocuronium and 30 receiving succinylcholine. Mean time to sedation or analgesia was longer in the rocuronium group when compared to the succinylcholine group at 34 ± 36 min vs. 16 ± 21 min (p = 0.002). In the presence of an EPh, the mean time t...Continue Reading

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Citations

Mar 30, 2016·The American Journal of Emergency Medicine·Gabrielle Jacknin, Michael C Overbeck
Nov 29, 2015·Emergency Medicine Clinics of North America·Michael C Overbeck
Jun 22, 2016·The American Journal of Emergency Medicine·Gabrielle Jacknin, Michael C Overbeck
Oct 28, 2017·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Brenna M FarmerLewis Nelson
Dec 15, 2017·Minerva anestesiologica·Sebastiaan J VreeswijkMarc P Buise
Aug 10, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·John C Sakles
Apr 22, 2020·JAMA : the Journal of the American Medical Association·Asad E Patanwala
Jan 23, 2021·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Melinda J OrtmannDavid E Zimmerman
Feb 1, 2019·Pediatric Emergency Care·Kathleen BergMatthew Wilkinson

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