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Titolo:
A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients
Autore:
Laurin, EG; Sakles, JC; Panacek, EA; Rantapaa, AA; Redd, J;
Indirizzi:
Univ Calif Davis, Med Ctr, Div Emergency Med, PSSB, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CA USA 95817 , PSSB, Sacramento, CA 95817 USA Univ Cincinnati, Med Ctr, Coll Med, Dept Emergency Med, Cincinnati, OH 45267 USA Univ Cincinnati Cincinnati OH USA 45267 ncy Med, Cincinnati, OH 45267 USA
Titolo Testata:
ACADEMIC EMERGENCY MEDICINE
fascicolo: 12, volume: 7, anno: 2000,
pagine: 1362 - 1369
SICI:
1069-6563(200012)7:12<1362:ACOSAR>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
DUCHENNE MUSCULAR-DYSTROPHY; INDUCED CARDIAC-ARREST; ADDUCTOR POLLICIS; AIRWAY MANAGEMENT; SUXAMETHONIUM; INDUCTION; VECURONIUM; MUSCLES; ONSET; THIOPENTONE;
Keywords:
rapid-sequence intubation; tracheal intubation; neuromuscular-blocking agents; succinylcholine; rocuronium;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Laurin, EG Univ Calif Davis, Med Ctr, Div Emergency Med, PSSB, Suite 2100,2315 Stockton Blvd, Sacramento, CA 95817 USA Univ Calif Davis Suite 2100,2315 Stockton Blvd Sacramento CA USA 95817
Citazione:
E.G. Laurin et al., "A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients", ACAD EM MED, 7(12), 2000, pp. 1362-1369

Abstract

Objective: To compare rocuronium and succinylcholine for rapid-sequence intubation (RSI) in the emergency department (ED). Methods: A one-year prospective cohort comparison study was performed using a data collection form completed at the time of intubation. Data collected included the reason for the neuromuscular-blocking agent (NMBA) chosen, the time to onset of paralysis, and any complications encountered. Three ten-paint numerical descriptorscales recorded the degree of body movement, vocal cord movement, and the physician's overall satisfaction with the extent of paralysis. Results: Succinylcholine was used in 382 patients and rocuronium was used in 138 (26% of all RSI) patients. The mean (+/- SD) times of onset of succinylcholine and rocuronium were 39 +/- 13 sec and 44 +/- 20 sec, respectively (p = 0.04). No patient desaturated and required assisted ventilations while waiting for paralysis to occur. Types of body movements were similar with the two agents, but less frequent with succinylcholine (median = 10, mean = 9.5 +/- 1.1) than rocuronium (median = 10, mean = 9.1 +/- 1.5) (p = 0.01). Vocal cordmovements were similar for succinylcholine (median = 10, mean = 9.2 +/- 1.6) and rocuronium (median = 9, mean = 9.0 +/- 1.6) (p = 0.15). The physician's overall satisfaction with the extent of paralysis was also higher for succinylcholine (median = 10, mean = 9.4 +/- 1.3) than rocuronium (median = 10, mean = 8.8 +/- 2.0) (p < 0.01). Only one complication, widening of the QRS complex secondary to succinylcholine use in a patient with unsuspected hyperkalemia, could be attributed to the choice of NMBA. Conclusions: Both succinylcholine and rocuronium produced fast and reliable paralysis for RSI. Although succinylcholine had a faster onset and provided more relaxation,the difference had no clinical significance. Approximately a fourth of ED RSI patients qualified for use of rocuronium using these high-risk criteria.

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Documento generato il 02/04/20 alle ore 12:16:30