Current practice of rapid sequence induction of anaesthesia in the UK - a national survey

Sajayan, Achuthan; Wicker, James; Ungureanu, N.; Mendonca, Cyprian; Kimani, Peter K.

doi:10.1093/bja/aew017

Cited by 68 publications

(61 citation statements)

References 36 publications

(23 reference statements)

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“…A recent national survey in the United Kingdom reported similar findings regarding the use of succinylcholine for RSI. 18 Most respondents (56%) used succinylcholine for RSI, but they used rocuronium in selected patients. Similarly, 20% of the respondents usually used rocuronium for RSI, but they chose succinylcholine for some selected patients.…”

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confidence: 99%

“…Un sondage récent réalisé dans l'ensemble du Royaume-Uni a rapporté des résultats semblables quant à l'utilisation de succinylcholine pour l'ISR. 18 La plupart des répondants (56 %) utilisaient la succinylcholine pour l'ISR, mais le rocuronium chez certains patients. De la même façon, 20 % des répondants utilisaient en général le rocuronium pour l'ISR, mais ont choisi la succinylcholine pour certains patients.…”

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Our love-hate relationship with succinylcholine: Is sugammadex any better?

Hung

McKeen

Huitink

2016

Can J Anesth/J Can Anesth

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Some years ago, a colleague provided anesthesia care to a healthy young adult male for an emergency open appendectomy. Standard of care at that time was a rapidsequence induction and intubation (RSI). Following denitrogenation, general anesthesia and muscle relaxation were achieved with fentanyl, thiopental, and succinylcholine. While maintaining cricoid pressure, tracheal intubation was successfully achieved using direct laryngoscopy. The appendectomy proceeded uneventfully. As the surgeon was closing the abdominal wound, he requested additional muscle relaxation, and accordingly, a small dose of intravenous succinylcholine (20 mg) was administered. Within one minute, asystole was witnessed on the electrocardiogram monitor and no carotid pulse was detected. Help was summoned and chest compressions were initiated. Cardiac rhythm, carotid pulse, and oxygen saturation quickly returned to normal after the administration of atropine. At the conclusion of the surgery and after tracheal extubation, the patient was taken to the recovery room awake in stable condition. The patient was informed that cardiac arrest had occurred in the operating room. Despite no apparent long-term postoperative sequelae, medicolegal action was pursued. Many meetings with the patient and his legal team subsequently followed, and although the case did not proceed to trial, all involved were left with a bad memory of the ugly side effects of succinylcholine.

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confidence: 99%

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Our love-hate relationship with succinylcholine: Is sugammadex any better?

Hung

McKeen

Huitink

2016

Can J Anesth/J Can Anesth

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“…‘Classic RSI’ (predetermined doses of thiopentol and succinylcholine without opioid use) is now rarely practiced in the UK . The higher incidence of AAGA associated with RSI suggests that it's time to change practice – to administer adequate, titrated doses of induction drugs before administering NMBs.…”

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confidence: 99%

Fifth national audit project handbook response

Rodney

Checketts

2019

Anaesthesia

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“…Despite this, the selection of neuromuscular blocking agent often results from the necessity to use an agent with the shortest possible time until achieving maximum blockade. Having considered its numerous side effects, succinyldicholine's position -as a drug of choice during rapid induction of anaesthesia -is becoming weaker, with its place being replaced by rocuronium [2,3]. The use of rocuronium in elderly people is associated with a significantly extended duration of the neuromuscular blockade [4,5].…”

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confidence: 99%