Comparison Of Rocuronium And Succinylcholine For Rapid Sequence Intubation In Emergency Department

Objective:Two methods of paralysis are available for rapid sequence intubation (RSI) in the emergency department (ED):depolarizing agents such as succinylcholine, and non-depolarizing drugs such as rocuronium. Rocuronium is a useful alternative when succinylcholine is contraindicated. Contraindications to succinylcholine include allergy, history of malignant hyperthermia, denervation syndromes, and patients who are 24-48 h post burn or crush injury. Non-depolarizing drugs have the advantage of causing less pain due to post-paralysis myalgias.We will discuss that if rocuronium can replace succinylcholine as the paralytic of choice for RSI in the ED.Methods:Four relevant studies were selected from an evidence search and a structured review performed.Results:For the outcomes of clinically acceptable intubation conditions and time to onset, the two agents were not statistically significantly different. Succinylcholine seems to produce conditions that have higher satisfaction scores.Conclusion:Succinylcholine remains the drug of choice for ED RSI unless there is a contraindication to its usage.