Mencke T, Zitzmann A, Reuter D A
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.
Anaesthesist. 2018 Apr;67(4):305-320. doi: 10.1007/s00101-018-0416-7.
Rapid sequence induction (RSI) is a specific technique for anesthesia induction, which is performed in patients with an increased risk for pulmonary aspiration (e.g. intestinal obstruction, severe injuries and cesarean section). The incidence of acute respiratory distress syndrome (ARDS) is very low but 10-30% of anesthesia-related deaths are caused by the consequences of ARDS. The classical RSI with its main components (i.e. head-up position, avoidance of positive pressure ventilation and administration of succinylcholine) was published nearly 50 years ago and has remained almost unchanged. The modified RSI consists of mask ventilation before endotracheal intubation is performed or the use of non-depolarizing muscle relaxants. Succinylcholine 1.0 mg/kg or rocuronium 1.0-1.2 mg/kg should be administered to achieve excellent intubation conditions. The use of cricoid pressure was a cornerstone of RSI after its introduction in 1961; however, after controversial discussions in recent years, cricoid pressure has lost its importance. Before surgery gastric emptying with a nasogastric tube is mandatory in patients with ileus and passage or defecation disorders.
快速顺序诱导（RSI）是一种用于麻醉诱导的特定技术，用于有肺误吸风险增加的患者（如肠梗阻、严重创伤和剖宫产）。急性呼吸窘迫综合征（ARDS）的发生率很低，但10%至30%的麻醉相关死亡是由ARDS的后果导致的。经典的RSI及其主要组成部分（即头高位、避免正压通气和给予琥珀酰胆碱）在近50年前就已发表，且几乎没有变化。改良的RSI包括在进行气管插管前进行面罩通气或使用非去极化肌松药。应给予1.0mg/kg的琥珀酰胆碱或1.0至1.2mg/kg的罗库溴铵以获得良好的插管条件。环状软骨压迫在1961年引入后是RSI的基石；然而，经过近年来的争议性讨论，环状软骨压迫已失去其重要性。对于肠梗阻以及有排便或排气障碍的患者，术前必须用鼻胃管进行胃排空。
