Comparative Effectiveness of Rocuronium and Succinylcholine in Rapid Sequence Intubation: A Systematic Review
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Background: Rocuronium and succinylcholine (suxamethonium) are neuromuscular blocking agents that may be considered for use in rapid sequence intubation (RSI). Rapid sequence intubation is an airway management technique that facilitates swift induction and muscle relaxation, recognized as the most expedient and successful method for securing the airway in emergencies. Therefore, the selection of an ideal muscle relaxant is essential in this setting.
Objective: This systematic review aims to evaluate and analyze the available evidence comparing the effectiveness of the muscle relaxants rocuronium and succinylcholine in patients undergoing rapid sequence intubation. Based on the search and screening process, four studies were included, which met the inclusion criteria and were analyzed further.
Methods: The literature search was conducted through electronic databases using specific keywords in published journal databases, including ScienceDirect, PubMed, and Google Scholar. The search terms used were muscle relaxant, rocuronium, succinylcholine, and rapid sequence intubation. Based on the search and screening process, four articles met the inclusion criteria and were analyzed further. These articles were evaluated to determine their relevance to the objectives of this systematic review. Data analysis was performed to identify the main findings regarding the comparison of the effectiveness of rocuronium and succinylcholine as muscle relaxants in patients undergoing rapid sequence intubation.
Results: This systematic review demonstrates that succinylcholine and rocuronium have comparable clinical quality and effectiveness. Analysis of the four articles that met the inclusion criteria revealed that both succinylcholine and rocuronium provide good and comparable effectiveness. These findings indicate that succinylcholine and rocuronium are appropriate muscle relaxants for rapid sequence intubation when used according to their respective indications and contraindications.
Conclusion: Based on the findings of this systematic review, it can be concluded that both succinylcholine and rocuronium can be used effectively for tracheal intubation, with acceptable intubation conditions in both groups. However, the use of succinylcholine and rocuronium should take into account patient-specific indications and contraindications.
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Hampton, J. P. (2011). Rapid-sequence intubation and the role of the emergency department pharmacist. American Journal of Health-System Pharmacy, 68(14), 1320–1330. https://doi.org/10.2146/ajhp100437
Klucka, J., Kosinova, M., Zacharowski, K., De Hert, S., Kratochvil, M., Toukalkova, M., Stoudek, R., Zelinkova, H., & Stourac, P. (2020). Rapid sequence induction: An international survey. European Journal of Anaesthesiology, 37(6), 435–442. https://doi.org/10.1097/EJA.0000000000001194
Li, G., Cheng, L., & Wang, J. (2021). Comparison of rocuronium with succinylcholine for rapid sequence induction intubation in the emergency department: A retrospective study at a single center in China. Medical Science Monitor, 27, e928462. https://doi.org/10.12659/MSM.928462
Marsch, S. C., Steiner, L., Bucher, E., Pargger, H., Schumann, M., Aebi, T., Hunziker, P. R., & Siegemund, M. (2011). Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: A prospective, randomized controlled trial. Critical Care, 15(4), R199. https://doi.org/10.1186/cc10367
Schrader, M., & Urits, I. (2025). Tracheal rapid sequence intubation. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560592/
Serge, N. N. (2021). Comparison between rocuronium and succinylcholine for rapid sequence induction in adults: Experience of a referral hospital in Central Africa. SAS Journal of Surgery, 8, 460–464.
Sinclair, R. C. F., & Luxton, M. C. (2005). Rapid sequence induction. Continuing Education in Anaesthesia Critical Care & Pain, 5(2), 45–48. https://doi.org/10.1093/bjaceaccp/mki016
Sluga, M., Ummenhofer, W., Studer, W., Siegemund, M., & Marsch, S. C. (2005). Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: A prospective, randomized trial in emergent cases. Anesthesia & Analgesia, 101(5), 1356–1361. https://doi.org/10.1213/01.ANE.0000180196.58567.FE
Tran, D. T., Newton, E. K., Mount, V. A., Lee, J. S., Wells, G. A., & Perry, J. J. (2015). Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database of Systematic Reviews, 2015(10), CD002788. https://doi.org/10.1002/14651858.CD002788.pub3
Vested, M., Creutzburg, A., Meyhoff, C. S., Rovsing, M. L., Nielsen, T., Rosa, F., Aasvang, E. K., Mollerup, H., Fuchs-Buder, T., & Rasmussen, L. S. (2025). Intubating conditions during rapid sequence induction with either rocuronium or suxamethonium in elderly patients: A randomised study. Acta Anaesthesiologica Scandinavica, 69(3), e1459. https://doi.org/10.1111/aas.1459
Wahid, F., Hussain, A., Rahman, F., & Rehman, O. (2020). Comparison of rocuronium and succinylcholine for rapid sequence induction in patients undergoing surgery under general anaesthesia. Journal of Rawalpindi Medical College, 24, 134–138. https://doi.org/10.37939/jrmc.v24i2.1258