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Related Experiment Videos

Are intubation conditions using rocuronium equivalent to those using succinylcholine?

Jeffrey Joseph Perry1, Jacques Lee, George Wells

  • 1Division of Emergency Medicine, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada. jperry@ohri.ca

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|August 3, 2002
PubMed
Summary

Succinylcholine provides superior intubation conditions compared to rocuronium. However, when combined with propofol, rocuronium achieves equivalent intubation conditions, making it a viable alternative for rapid-sequence induction.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Critical Care Medicine

Background:

  • Rapid-sequence induction (RSI) requires effective neuromuscular blocking agents for optimal intubation conditions.
  • Succinylcholine has been the traditional agent, but concerns regarding its side effects exist.
  • Rocuronium is a newer alternative, necessitating a comparison of its intubating efficacy.

Purpose of the Study:

  • To compare the intubation conditions provided by rocuronium versus succinylcholine during RSI.
  • To determine if rocuronium is equivalent to succinylcholine for achieving excellent intubation conditions.
  • To explore factors influencing intubation success with these agents.

Main Methods:

  • A systematic review and meta-analysis of randomized clinical trials (RCTs) were conducted.

Related Experiment Videos

  • Searched Medline, EMBASE, and Cochrane Controlled Trials Register for relevant studies.
  • Intubation conditions were assessed using Goldberg's scale; equivalence was defined by a sample size of 468.

    • Main Results:

    • Analysis of 26 studies (N=1,606) revealed rocuronium was inferior to succinylcholine (RR=0.87).
    • However, in the propofol subgroup (N=640), intubation conditions were equivalent (RR=0.96).
    • Rates of failed intubations were similar between the two agents.

    Conclusions:

    • Succinylcholine generally offers more reliable excellent intubation conditions than rocuronium.
    • Rocuronium, when administered with propofol, provides intubation conditions comparable to succinylcholine.
    • Rocuronium is a suitable alternative to succinylcholine, particularly when used with propofol.