succinylcholine versus rocuronium for rapid sequence intubation in intensive care a prospective, randomized controlled trial琥珀酰胆碱与rocuronium快速序列插管在重症监护前瞻性随机对照试验.pdfVIP

Marsch et al. Critical Care 2011, 15:R199 /content/15/4/R199 RESEARCH Open Access Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: a prospective, randomized controlled trial 1* 1,2 1,2 2 1,2 1 Stephan C Marsch , Luzius Steiner , Evelyne Bucher , Hans Pargger , Martin Schumann , Timothy Aebi , Patrick R Hunziker1 and Martin Siegemund1,2 Abstract Introduction: Succinylcholine and rocuronium are widely used to facilitate rapid sequence induction (RSI) intubation in intensive care. Concerns relate to the side effects of succinylcholine and to slower onset and inferior intubation conditions associated with rocuronium. So far, succinylcholine and rocuronium have not been compared in an adequately powered randomized trial in intensive care. Accordingly, the aim of the present study was to compare the incidence of hypoxemia after rocuronium or succinylcholine in critically ill patients requiring an emergent RSI. Methods: This was a prospective randomized controlled single-blind trial conducted from 2006 to 2010 at the University Hospital of Basel. Participants were 401 critically ill patients requiring emergent RSI. Patients were randomized to receive 1 mg/kg succinylcholine or 0.6 mg/kg rocuronium for neuromuscular blockade. The primary outcome was the incidence of oxygen desaturations defined as a decrease in oxygen saturation ≥ 5%, assessed by continuous pulse oxymetry, at any time between the start of the induction sequence and two minutes after the completion of the intubation. A severe oxygen desaturation was defined as a decrease in oxygen saturation ≥ 5% leading to a saturation value of ≤ 80%. Results: There was no difference