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Related Concept Videos

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...
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Related Experiment Video

Updated: Jun 18, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation
03:58

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Remifentanil Versus Rocuronium for Optimising Video Laryngoscopy Assisted Tracheal Intubation-The ROCVIDEO Trial

Emil Ørskov Ipsen1, Lars Hyldborg Lundstrøm1,2,3, Åse Lodenius4,5

  • 1Department of Anaesthesiology, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark.

Acta Anaesthesiologica Scandinavica
|June 17, 2026
PubMed
Summary
This summary is machine-generated.

This study compares rocuronium versus remifentanil for tracheal intubation using video laryngoscopy. It aims to determine which agent reduces failed first-pass intubation and anesthesia-related adverse events.

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Area of Science:

  • Anesthesiology
  • Airway Management
  • Clinical Trials

Background:

  • Neuromuscular blocking agents (NMBAs) facilitate tracheal intubation but carry risks like respiratory complications and anaphylaxis.
  • Bolus remifentanil is an alternative, yet its efficacy with video laryngoscopy for first-pass success is not well-established.
  • The ROCVIDEO trial investigates the safety and efficacy of rocuronium compared to remifentanil for intubation.

Purpose of the Study:

  • To compare the effectiveness of rocuronium versus remifentanil in reducing failed first-pass tracheal intubation.
  • To evaluate the incidence of anesthesia-related adverse events associated with each agent during video laryngoscopy-assisted intubation.
  • To assess secondary outcomes including patient satisfaction and post-anesthesia care unit length of stay.

Main Methods:

  • A blinded, randomized, controlled trial (ROCVIDEO) involving 2684 adult participants (ASA-class I-III).
  • Participants receive either rocuronium (0.6 mg/kg) or remifentanil (4 μg/kg) for anesthesia induction prior to video laryngoscopy-assisted orotracheal intubation.
  • Co-primary outcomes include failed first-pass intubation and anesthesia-related adverse events, with a two-sided alpha of 0.025.

Main Results:

  • Recruitment is ongoing, with 707 participants randomized across 15 sites as of June 15, 2026.
  • Full results are pending completion of participant recruitment in Q3 2027.
  • The study is powered to detect a 30% relative risk reduction in failed first-pass intubation and anesthesia-related adverse events.

Conclusions:

  • The ROCVIDEO trial will provide high-quality evidence on the optimal agent for tracheal intubation.
  • Findings are expected to inform clinical guidelines and improve global airway management practices.
  • Even small differences in intubation success rates can have significant clinical implications globally.