In a randomized trial, patients receiving rocuronium followed by a saline flush had an earlier onset of neuromuscular blockade than those receiving rocuronium alone.
Reliable, rapid onset of neuromuscular blockade is critical for successful emergency rapid sequence intubation (RSI). Rocuronium has a slower onset than succinylcholine. The effect of a large-volume saline flush on rocuronium's onset time is not known.
Researchers at a Japanese military hospital randomized 48 healthy non-obese patients to rocuronium (0.6 mg/kg IV) with or without a 20 mL saline flush. Anesthesia was induced with standard infusions of propofol and remifentanil. All medications were administered through a 20- or 22-gauge catheter in a large-caliber forearm vein.
The average onset of neuromuscular blockade (defined as ≥95% muscle twitch depression) was 15 seconds shorter in the saline-flush group than the placebo group. The reco…
Reviewing Author
DisclosuresConsultant / Advisory boardVerathon, Inc. (Scientific Advisory Board Member)
Editorial boardsScientific American Emergency Medicine; Manual of Emergency Airway Management (Editor-in-Chief)
Leadership positions in professional societiesPrograms Subcommittee Chair for the Society for Academic Emergency Medicine–Residency and Fellowship Fair
DisclosuresConsultant / Advisory boardVerathon, Inc. (Scientific Advisory Board Member)
Editorial boardsScientific American Emergency Medicine; Manual of Emergency Airway Management (Editor-in-Chief)
Leadership positions in professional societiesPrograms Subcommittee Chair for the Society for Academic Emergency Medicine–Residency and Fellowship Fair