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Succinylcholine (SCh) remains the drug of choice for ED rapid sequence intubation (RSI), but rocuronium is increasingly used when SCh is contraindicated. This English study compared two induction agents -- etomidate and propofol -- for RSI done with rocuronium in 71 healthy adults without known airway problems.
Patients were randomized to either IV propofol (2.5 mg/kg) or IV etomidate (0.3 mg/kg), titrated until they were unresponsive to verbal stimulation. The agents were followed by rocuronium (0.6 mg/kg); 45 seconds thereafter, Sellick's maneuver was applied and laryngoscopy was attempted. Intubating conditions were good to excellent in 94% of the propofol group versus 75% of the etomidate group (p=0.025). Systolic blood pressure dropped …