Comparison of rocuronium priming vs. standard rapid sequence intubation technique in emergency department patients requiring intubation

Rev Assoc Med Bras (1992). 2024 Apr 22;70(3):e20231029. doi: 10.1590/1806-9282.20231029. eCollection 2024.

Abstract

Objective: In our study, we aimed to compare the effect of standard rapid sequence intubation protocol and the application of rocuronium priming technique on the procedure time and hemodynamic profile.

Methods: Patients who applied to the emergency department and needed rapid sequence intubation were included in our study, which we conducted with a randomized controlled design. Randomization in the study was made according to the order of arrival of the cases. Rapid sequence intubation was performed in the standard group. In the priming group, 10% of the rocuronium dose was administered approximately 3 min before the induction agent. Intubation time, amount of drug used, vital signs, and end-tidal CO2 level before and after intubation used to confirm intubation were recorded.

Results: A total of 52 patients were included in the study, of which 26 patients were included in the standard group and 26 patients in the priming group. While intubation time was 121.2±21.9 s in the standard group, it was calculated as 68.4±11.6 s in the priming group (p<0.001). While the mean arterial pressure was 58.3±26.6 mmHg in the standard group after intubation, it was 80.6±21.1 mmHg in the priming group (p=0.002).

Conclusion: It was observed that priming with rocuronium shortened the intubation time and preserved the hemodynamic profile better.

Clinical trial registration number: NCT05343702.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Androstanols* / administration & dosage
  • Emergency Service, Hospital*
  • Female
  • Hemodynamics / drug effects
  • Humans
  • Intubation, Intratracheal* / methods
  • Male
  • Middle Aged
  • Neuromuscular Nondepolarizing Agents* / administration & dosage
  • Rapid Sequence Induction and Intubation* / methods
  • Rocuronium* / administration & dosage
  • Time Factors

Substances

  • Rocuronium
  • Neuromuscular Nondepolarizing Agents
  • Androstanols

Associated data

  • ClinicalTrials.gov/NCT05343702