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Succinylcholine or rocuronium? A meta-analysis of the effects on intubation conditions


Ozgur Karcioglu, MD, Associate Professor in Emergency Medicine, Department of Emergency Medicine, Dokuz Eylul University Medical School, Inciralti, Izmir 35340, Turkey


This meta-analysis was undertaken to compare the effects of succinylcholine (SCH) and rocuronium (RCR) on endotracheal intubation (ETI) conditions. Eligible randomised controlled trials (RCTs) were identified via medline and a manual search of references. The frequencies of excellent and unacceptable ETI conditions in subjects receiving SCH 1.0–1.5 mg/kg and RCR 0.6–1.2 mg/kg were determined using standard statistical methods. Inclusion criteria were met by 16 RCTs, representing 1362 subjects. SCH was associated with a 17.7% increase (95% CI = 13–22) in the frequency of excellent ETI conditions and a 5.1% decrease (95% CI = −7.3 to −2.9) in the frequency of unacceptable ETI conditions, when compared with RCR. In the subgroup undergoing true rapid sequence intubation, SCH was associated with a 19.1% increase (95% CI = 13.7–24.5) in the frequency of excellent ETI conditions. SCH appears to be superior to RCR in creating excellent ETI conditions and avoiding unacceptable ETI conditions.

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