What drugs are used in rapid sequence intubation?
Drugs used in rapid sequence intubation (RSI) are as follows:
- Potent anesthetic agent
- Muscle relaxants or paralytic agents
- Pharmacological adjuncts
Potent anesthetic agents include the following:
- Propofol: It is used for patients who have unstable vital signs.
- Ketamine: It is used in prehospital settings and in unstable patients.
- Etomidate: It is used to suppress adrenaline effects on patients.
- Thiopentone: It has the most rapid onset of action.
- Midazolam: It is most suitable in patients who are already having decreased consciousness.
Muscle relaxants or paralytic agents include the following:
- Suxamethonium (succinylcholine): It is the most common muscle relaxant used in RSI.
- Rocuronium: It takes effect within 45-60 seconds.
- Pharmacological adjuncts include the following:
- Lidocaine (lignocaine)
In patients who are under shock, no adjuncts may be required. However, in systemically well patients or patients at a risk of severe hypertension during induction, pharmacological adjuncts are used.