Department of Anesthesiology, Dangyang People's Hospital, Dangyang, Hubei, China (mainland).
Department of Anesthesiology, Yichang Central People's Hospital and The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, China (mainland).
Med Sci Monit. 2021 Jan 14;27:e928462. doi: 10.12659/MSM.928462.
BACKGROUND This retrospective study was conducted at a single center in China and aimed to compare rocuronium with succinylcholine for rapid sequence induction intubation in the Emergency Department of a hospital. MATERIAL AND METHODS An orotracheal intubation procedure was performed in a total of 267 patients by direct laryngoscopy using an intravenous bolus injection of 1 mg/kg of succinylcholine (n=141; SY group) or 1.2 mg/kg of rocuronium (n=126; RM group) for a rapid sequence induction in the emergency department. The success of orotracheal intubation was evaluated by a capnography curve. The modified Cormack-Lehane score was used to grade the direct laryngoscopy. RESULTS There was no statistically significant difference in numbers of patients with successful first-attempt orotracheal intubation between the groups (112 vs. 87, P=0.067). Fewer intubation failures under direct laryngoscopy were reported in the SY group than in the RM group (23 [16%] vs. 34 [27%], P=0.037). The number of intubation attempts was higher in the RM group than in the SY group (1.52±0.87 per patient vs. 1.27±0.60 per patient, P=0.032). CONCLUSIONS The findings from this study support results from previous studies, showing that even in the Emergency Department setting, rocuronium was equivalent to succinylcholine in achieving rapid sequence induction intubation, when the dose was appropriate. However, as current clinical guidelines highlight, succinylcholine has more contraindications and adverse effects, including hyperkalemia, which should be monitored, and rocuronium has a longer duration of action.
本回顾性研究在中国的一家中心进行，旨在比较罗库溴铵与琥珀酰胆碱在医院急诊科进行快速序贯诱导插管中的作用。
共有 267 名患者通过直接喉镜进行经口气管插管，其中 141 名患者静脉推注 1mg/kg 琥珀酰胆碱（SY 组），126 名患者静脉推注 1.2mg/kg 罗库溴铵（RM 组）进行快速序贯诱导。通过二氧化碳描记曲线评估经口气管插管的成功率。改良的 Cormack-Lehane 评分用于对直接喉镜检查进行分级。
两组患者首次尝试经口气管插管成功的患者人数无统计学差异（112 例 vs. 87 例，P=0.067）。SY 组中直接喉镜下插管失败的患者少于 RM 组（23 [16%] 例 vs. 34 [27%] 例，P=0.037）。RM 组的插管尝试次数高于 SY 组（每名患者 1.52±0.87 次 vs. 每名患者 1.27±0.60 次，P=0.032）。
本研究结果支持既往研究结果，表明即使在急诊科环境中，当剂量合适时，罗库溴铵与琥珀酰胆碱在实现快速序贯诱导插管方面同样有效。然而，正如当前的临床指南所强调的，琥珀酰胆碱的禁忌症和不良反应更多，包括高钾血症，需要进行监测，而罗库溴铵的作用持续时间更长。
