Department of Emergency Medicine, University of Florida College of Medicine–Jacksonville, Jacksonville, FL, USA.
Ann Emerg Med. 2011 Mar;57(3):234-7. doi: 10.1016/j.annemergmed.2010.10.017. Epub 2011 Jan 8.
We determine whether pharmacologic neuromuscular blockade with succinylcholine or rocuronium during emergency rapid sequence intubation affects pupillary response to light.
This was a prospective case series of patients undergoing rapid sequence intubation between February 2008 and February 2009. Two blinded, independent emergency physicians assessed pupillary response after administration of neuromuscular blockade and intubation. Cases without pupillary response before rapid sequence intubation were excluded. The primary outcome measure was clinically observable pupillary response.
We studied 94 patients undergoing rapid sequence intubation, including 67 (71%) receiving succinylcholine and 27 (31%) receiving rocuronium. Of patients receiving succinylcholine, 61 of 67 (91%; 95% confidence interval 82% to 97%) demonstrated pupillary response after rapid sequence intubation. All patients receiving rocuronium demonstrated preserved pupillary reflexes. κ For interobserver agreement was 0.66.
Succinylcholine and rocuronium do not appear to inhibit pupillary response in patients undergoing emergency department rapid sequence intubation.
我们确定在急诊快速序贯插管期间使用琥珀酰胆碱或罗库溴铵进行药物神经肌肉阻滞是否会影响瞳孔对光的反应。
这是一项 2008 年 2 月至 2009 年 2 月期间进行的快速序贯插管的前瞻性病例系列研究。两名盲法、独立的急诊医生在神经肌肉阻滞和插管后评估瞳孔反应。快速序贯插管前无瞳孔反应的病例被排除在外。主要观察指标是临床可观察到的瞳孔反应。
我们研究了 94 例接受快速序贯插管的患者，其中 67 例（71%）接受琥珀酰胆碱，27 例（31%）接受罗库溴铵。接受琥珀酰胆碱的患者中，67 例中的 61 例（91%；95%置信区间 82%至 97%）在快速序贯插管后出现瞳孔反应。所有接受罗库溴铵的患者均表现出保留的瞳孔反射。观察者间一致性的κ 值为 0.66。
琥珀酰胆碱和罗库溴铵似乎不会抑制急诊科快速序贯插管患者的瞳孔反应。
