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Succinylcholine Versus Rocuronium for Emergency Intubation in Intensive Care

NCT ID: NCT00355368

Last Updated: 2011-12-15

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

420 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-08-31

Study Completion Date

2010-07-31

Brief Summary

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Emergency intubation of patients in intensive care is a high-risk endeavour. For many decades, succinylcholine has been the neuromuscular blocking agent of choice. However, succinylcholine may have life-threatening side effects and is contraindicated in a variety of diseases relevant in intensive care. The nondepolarizing agent rocuronium has been propagated as alternative for succinylcholine. Though a recent meta-analysis found no difference in intubating conditions between succinylcholine and rocuronium in elective cases, there are no data in emergent cases in intensive care. The aim of the present study is to compare succinylcholine and rocuronium with regard to 1) quality of intubating conditions, 2) length of the intubating sequence, 3) failed intubating attempts, 4) hemodynamic sequelae of intubation, and 5) desaturations.

Detailed Description

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Objective: to compare succinylcholine and rocuronium with regard to 1) quality of intubating conditions, 2) length of the intubating sequence, 3) failed intubating attempts, 4) hemodynamic sequelae of intubation, and 5) desaturations.

Design: prospective, randomized, single-blind study. Setting: Intensive care units of an University Hospital. Patients: adult patients in intensive care requiring emergency intubation. Randomization: 1:1 randomization to either succinylcholine (1mg/kg) or rocuronium (0.6 mg/kg).

Data: 1) assessment of the quality of intubating conditions by means of a score, 2) length of the intubating sequence defined as time between injection of neuromuscular blocking agent and first end-tidal CO2 on the monitor, 3) number of failed intubating attempts, 4) hemodynamic sequelae of intubation, defined as events requiring injection of vasoactive drugs, and 5) desaturations, defined as saturation below 90% and/or any decrease in saturation of 5% or more.

Conditions

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Intubation

Keywords

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intubation intensive care neuromuscular depolarizing agents neuromuscular nondepolarizing agents neuromuscular blocking agents

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Succinylcholine

Group Type ACTIVE_COMPARATOR

Succinylcholine

Intervention Type DRUG

1mg/kg iv

Rocuronium

Group Type ACTIVE_COMPARATOR

Rocuronium

Intervention Type DRUG

0.6mg/kg iv

Interventions

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Succinylcholine

1mg/kg iv

Intervention Type DRUG

Rocuronium

0.6mg/kg iv

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* indication for emergency intubation in intensive care
* availability of qualified study physician

Exclusion Criteria

* contraindication against succinylcholine or rocuronium
* indication for awake fibreoptic intubation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Basel, Switzerland

OTHER

Sponsor Role lead

Responsible Party

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Stephan Marsch

Professor and Chairman of Medical ICU

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Martin Siegemund, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Surgical Intensive Care, University of Basel

Stephan C Marsch, MD, DPhil

Role: PRINCIPAL_INVESTIGATOR

Department of Medical Intensive Care, University of Basel

Locations

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Department of Medical Intensive Care; University of Basel

Basel, Canton of Basel-City, Switzerland

Site Status

Countries

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Switzerland

References

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Sluga M, Ummenhofer W, Studer W, Siegemund M, Marsch SC. Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: a prospective, randomized trial in emergent cases. Anesth Analg. 2005 Nov;101(5):1356-1361. doi: 10.1213/01.ANE.0000180196.58567.FE.

Reference Type BACKGROUND
PMID: 16243994 (View on PubMed)

Marsch SC, Steiner L, Bucher E, Pargger H, Schumann M, Aebi T, Hunziker PR, Siegemund M. Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: a prospective, randomized controlled trial. Crit Care. 2011 Aug 16;15(4):R199. doi: 10.1186/cc10367.

Reference Type DERIVED
PMID: 21846380 (View on PubMed)

Other Identifiers

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EK 145/05

Identifier Type: -

Identifier Source: org_study_id