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Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics01:11

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacokinetics

All neuromuscular blocking agents are injected intravenously because they are poorly absorbed from the GI tract. Rapid onset is achieved with intravenous administration, although absorption is also adequate from an intramuscular injection. Since these agents are highly ionized, they do not readily penetrate cell membranes or cross the blood-brain barrier.
Instead, they are transported by the blood to different tissues. Muscles with a greater blood supply (arteries) and blood flow receive more...
Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because succinylcholine...
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action01:17

Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action

Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...

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An Improved Method for Rapid Intubation of the Trachea in Mice
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An Improved Method for Rapid Intubation of the Trachea in Mice

Published on: February 22, 2016

Newer agents for rapid sequence intubation: etomidate and rocuronium.

Kevin Y Ching1, Carl R Baum

  • 1Section of Pediatric Emergency Medicine, Department of Pediatrics, Yale-New Haven Children's Hospital, Yale University School of Medicine, New Haven, CT 06504, USA.

Pediatric Emergency Care
|March 17, 2009
PubMed
Summary

Etomidate and rocuronium are effective sedating and paralyzing agents for pediatric rapid sequence intubation, offering rapid onset and minimal hemodynamic effects. However, etomidate

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Last Updated: Jun 24, 2026

An Improved Method for Rapid Intubation of the Trachea in Mice
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Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
05:43

Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow

Published on: January 13, 2017

Area of Science:

  • Pediatric Emergency Medicine
  • Anesthesiology
  • Critical Care

Background:

  • Rapid sequence intubation (RSI) is crucial for emergency airway management in critically ill children and adolescents.
  • Etomidate and rocuronium are increasingly utilized for sedation and neuromuscular blockade during pediatric RSI.
  • Both agents offer advantages such as rapid onset and favorable hemodynamic profiles.

Purpose of the Study:

  • To review the safety and efficacy of etomidate and rocuronium in pediatric RSI.
  • To highlight the benefits and potential controversies surrounding their use.

Main Methods:

  • Literature review of existing evidence on etomidate and rocuronium in pediatric RSI.
  • Analysis of pharmacokinetic and pharmacodynamic properties.
  • Evaluation of adverse effects and contraindications.

Main Results:

  • Etomidate and rocuronium provide rapid onset of action and are generally well-tolerated hemodynamically.
  • Rocuronium offers effective intubating conditions, avoiding succinylcholine-related complications.
  • Etomidate's adrenal suppression raises concerns, particularly in pediatric septic shock cases.

Conclusions:

  • Current evidence supports the safety of etomidate and rocuronium for pediatric RSI.
  • Further prospective studies are warranted to solidify their role and address specific patient populations, like those with septic shock.