Stollings Joanna L, Diedrich Daniel A, Oyen Lance J, Brown Daniel R
Vanderbilt University Medical Center, Nashville, TN, USA.
Ann Pharmacother. 2014 Jan;48(1):62-76. doi: 10.1177/1060028013510488. Epub 2013 Nov 4.
To summarize published data regarding the steps of rapid-sequence intubation (RSI); review premedications, induction agents, neuromuscular blockers (NMB), and studies supporting use or avoidance; and discuss the benefits and deficits of combinations of induction agents and NMBs used when drug shortages occur.
A search of Medline databases (1966-October 2013) was conducted.
Databases were searched using the terms rapid-sequence intubation, fentanyl, midazolam, atropine, lidocaine, phenylephrine, ketamine, propofol, etomidate thiopental, succinylcholine, vecuronium, atracurium, and rocuronium. Citations from publications were reviewed for additional references.
Data were reviewed to support the use or avoidance of premedications, induction agents, and paralytics and combinations to consider when drug shortages occur.
RSI is used to secure a definitive airway in often uncooperative, nonfasted, unstable, and/or critically ill patients. Choosing the appropriate premedication, induction drug, and paralytic will maximize the success of tracheal intubation and minimize complications.
总结已发表的关于快速顺序诱导插管（RSI）步骤的数据；回顾预处理药物、诱导剂、神经肌肉阻滞剂（NMB）以及支持其使用或避免使用的研究；并讨论在药物短缺时使用的诱导剂和NMB组合的优缺点。
对Medline数据库（1966年 - 2013年10月）进行了检索。
使用快速顺序诱导插管、芬太尼、咪达唑仑、阿托品、利多卡因、去氧肾上腺素、氯胺酮、丙泊酚、依托咪酯、硫喷妥钠、琥珀酰胆碱、维库溴铵、阿曲库铵和罗库溴铵等检索词对数据库进行检索。对出版物中的参考文献进行了回顾以获取更多参考资料。
对数据进行了回顾，以支持预处理药物、诱导剂和麻痹剂的使用或避免使用，以及在药物短缺时应考虑的组合。
RSI用于在通常不合作、未禁食、不稳定和/或危重病患者中确保建立确定性气道。选择合适的预处理药物、诱导药物和麻痹剂将使气管插管成功率最大化并使并发症最小化。
