Related Experiment Video
Updated: Jun 9, 2026
05:39
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Rapid Sequence Induction Practices and Outcomes in Abdominal Surgery Patients: A Multicenter Observational Cohort
Sivan G Marcus1, Michael Mathis2, Michael P Bokoch3
1Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California.
Anesthesiology
|June 8, 2026
Summary
Rocuronium is increasingly replacing succinylcholine for Rapid Sequence Induction (RSI) in abdominal surgery. This shift in neuromuscular blocking agent use did not impact patient mortality or complication rates.
Area of Science:
- Anesthesiology
- Perioperative Medicine
- Critical Care
Background:
- Rapid Sequence Induction (RSI) is crucial for airway management during abdominal surgery to prevent aspiration.
- Current anesthesiology practices for RSI medications and techniques are not well-documented.
Purpose of the Study:
- To describe contemporary RSI practices in adult patients undergoing abdominal surgery.
- To evaluate trends in neuromuscular blocking agent (NMB) utilization over time.
- To compare outcomes associated with different NMBs.
Main Methods:
- Observational cohort study using the Multicenter Perioperative Outcomes Group database (2015-2022).
- Analysis of peri-induction medication and intubation techniques.
- Statistical analysis including mixed-effects models and targeted maximum likelihood estimation.
Main Results:
- Succinylcholine use decreased from 85.4% in 2015 to 37.3% in 2022, with rocuronium becoming more prevalent.
- Video laryngoscopy use increased significantly in RSI cases.
- Rocuronium use showed no significant difference in 30-day mortality, hypoxia, pulmonary complications, or acute kidney injury compared to succinylcholine.
Conclusions:
- Rocuronium has become the preferred agent for RSI in US institutions, surpassing succinylcholine.
- The transition to rocuronium for RSI is not associated with adverse changes in key patient outcomes.
