Effect of Remifentanil vs Neuromuscular Blockers During Rapid Sequence Intubation on Successful Intubation Without Major Complications Among Patients at Risk of Aspiration: A Randomized Clinical Trial

IMPORTANCE: It is uncertain whether a rapid-onset opioid is noninferior to a rapid-onset neuromuscular blocker during rapid sequence intubation when used in conjunction with a hypnotic agent. OBJECTIVE: To determine whether remifentanil is noninferior to rapid-onset neuromuscular blockers for rapid...

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Veröffentlicht in:	JAMA : the journal of the American Medical Association 2023-01, Vol.329 (1), p.28-38
Hauptverfasser:	Grillot, Nicolas, Lebuffe, Gilles, Huet, Olivier, Lasocki, Sigismond, Pichon, Xavier, Oudot, Mathieu, Bruneau, Nathalie, David, Jean-Stéphane, Bouzat, Pierre, Jobert, Alexandra, Tching-Sin, Martine, Feuillet, Fanny, Cinotti, Raphael, Asehnoune, Karim, Roquilly, Antoine
Format:	Artikel
Sprache:	eng
Schlagworte:	Adult Adults Aged Analgesics, Opioid - administration & dosage Analgesics, Opioid - adverse effects Analgesics, Opioid - therapeutic use Anaphylaxis Arrhythmia Clinical trials Complications Desaturation Female Gastroesophageal reflux Hemodynamics Humans Hypnotics and Sedatives - administration & dosage Hypnotics and Sedatives - adverse effects Hypnotics and Sedatives - therapeutic use Intubation Intubation, Intratracheal - adverse effects Intubation, Intratracheal - methods Life Sciences Male Middle Aged Neuromuscular Blocking Agents - administration & dosage Neuromuscular Blocking Agents - adverse effects Neuromuscular Blocking Agents - therapeutic use Occlusion Original Investigation Patients Randomization Rapid Sequence Induction and Intubation - adverse effects Rapid Sequence Induction and Intubation - methods Remifentanil Remifentanil - administration & dosage Remifentanil - adverse effects Remifentanil - therapeutic use Respiratory Aspiration - etiology Respiratory Aspiration - prevention & control Risk Trauma
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Zusammenfassung:	IMPORTANCE: It is uncertain whether a rapid-onset opioid is noninferior to a rapid-onset neuromuscular blocker during rapid sequence intubation when used in conjunction with a hypnotic agent. OBJECTIVE: To determine whether remifentanil is noninferior to rapid-onset neuromuscular blockers for rapid sequence intubation. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized, open-label, noninferiority trial among 1150 adults at risk of aspiration (fasting for
ISSN:	0098-7484 1538-3598
DOI:	10.1001/jama.2022.23550