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Updated: Jun 2, 2026
08:46
An Improved Method for Rapid Intubation of the Trachea in Mice
Published on: February 22, 2016
Rocuronium versus succinylcholine in air medical rapid-sequence intubation
Brian Hiestand1, Michael T Cudnik, David Thomson
1Department of Emergency Medicine BH, Wake Forest University, Winston-Salem, North Carolina 27157, USA. bhiestan@wfubmc.edu
Prehospital Emergency Care
|May 17, 2011
Summary
Succinylcholine improved first-attempt intubation success and reduced the number of attempts during air medical rapid-sequence intubation (RSI) compared to rocuronium. Further randomized studies are recommended to confirm these findings.
Area of Science:
- Emergency Medicine
- Anesthesiology
- Critical Care
Background:
- Rocuronium and succinylcholine are neuromuscular blocking agents used in rapid-sequence intubation (RSI).
- Their comparative effectiveness in air medical RSI is not well-established.
- This study addresses the knowledge gap regarding their impact on intubation success in prehospital settings.
Purpose of the Study:
- To evaluate the impact of succinylcholine on the success rate of prehospital intubation.
- To compare the effectiveness of succinylcholine versus rocuronium in air medical rapid-sequence intubation.
Main Methods:
- Retrospective analysis of a critical care transport database (2004-2008).
- Included adult patients requiring airway management with rocuronium or succinylcholine.
- Propensity score adjustment and logistic regression were used to analyze first-attempt intubation success and number of attempts.
Main Results:
- Succinylcholine was associated with a higher incidence of first-attempt intubation (OR 1.4, 95% CI 1.1-1.8).
- Succinylcholine use improved the odds of requiring fewer intubation attempts (OR 1.5, 95% CI 1.2-1.9) compared to rocuronium.
- Of 1,045 patients, 46% received succinylcholine, and 59% were intubated on the first attempt.
Conclusions:
- Succinylcholine demonstrated greater success with fewer attempts in air medical RSI compared to rocuronium.
- Prospective, randomized studies are needed to validate these findings.
- Further research should explore succinylcholine's impact on overall outcomes in air medical transport.
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