Comparison evaluation of tracheal intubation with and without succinylcholine administration in emergency department

Background and

Succinylcholine isn’t used in Emergency Department intubations routinely, that, this study was performed to compare success and complications of tracheal intubation with and without succinylcholine administration.

This interventional study was done on 150 patients admitted in Emergency Department of Hazrat Rasoul Akram Hospital who underwent intratracheal intubation. Demographic data were evaluated. The Cases were entered in protocol A (rapid sequence intubation with succinylcholine) or B (modified RSI without succinylcholine) randomly and then intubated. During and after intubations, results and complications were recorded in checklists and analyzed via SPSS11 software.

The mean age in group A was 34.1±5.1 yrs while in group B was 35.1±5.3 yrs. In group A, 35 cases (46.6%) were female and 40 cases (53.4%) were male and in group B 37 cases (49.3%) were female and 38 cases (50.7%) were male. The differences between groups were not significant. In group A, 74 cases (98%) were intubated in first attempt and 1 case (2%) in second attempt. Bradicardia was seen in 3 cases (4%), hypotension in 8 cases (10.6 %), vomiting in 8 cases (2.6 %), hypertension in 2 cases (2.6 %) and hypoxia (O2 sat<90%) in 9 cases (12%). In group B, 64 cases (88%) were intubated in first attempt and 9 cases (12%) in second attempt. Bradicardia occurred in 2 cases (2.6%), hypotension in 9 cases (12%), vomiting in 3 cases (4%), hypoxia in 11 cases (14%) and hypertension in no case. In this study, the success rate of intubation in RSI with succynilcholine was higher significantly. There are no significant differences regarding in complications between two groups.

Our study showed that in emergency patients intubation the which there is no contraindication for succynilcholine, it is better to try RSI.