In Mesebetsi ea Tšohanyetso ho pota lefatše, ho phomola e etsoa mme ke ts'ebetso e mahlonoko ka lebaka la maemo a eona mme ehlile, ka lebaka la bophahamo ba mokuli.

Li-intubations tsa ED ka tloaelo li kenyelletsa ho kenella ka tatellano ea tatellano, ka ho kopantsoe ha moemeli ea thetsang le moriana o thethefatsang maikutlo, leha ho le joalo ho boetse ho na le tsela ea bobeli ea ho kenella, e leng ka tšebeliso ea succinylcholine khahlanong le rocuronium.

Ho tsamaisa katleho ea pele-pele le ho fokotsa liketsahalo tse bohloko, ho bohlokoa ho fihlella maemo a potlakisang ho futhumatsa ho bohlokoa. Ho holofala litho ho ka ama sekhahla sa katleho haeba ho sebelisoa ancinylcholine le rocuronium. Le ha lingoliloeng tsa anesthesia e fana ka maikutlo a maemo a matle bakeng sa tatellano e potlakileng ea ts'ebetso e nang le succinylcholine ho feta rocuronium, karohano e matla ka ho fetisisa ea tatelano ea kapele ea ED e lula e sa tsejoe.

mekhoa

Re ile ra sekaseka datha tse ka bokamoso tse tsoang ho National Emergency Airway Registry, registry ea multicenter e bokellang data ho li-intubations tsohle tse etsoang ka li-ED tsa 22.

Re kenyelelitse bakuli ba lilemo tse ka tlase ho 14 ba amohetseng succinylcholine kapa rocuronium ka selemo sa 2016. Re bapisitse katleho ea pele ea ho kenella lipakeng tsa bakuli ba fumanang succinylcholine le ba fumanang rocuronium.

Re boetse re bapisa liketsahalo tse mpe (ho tšoaroa ha pelo, ho sithabela ha meno, ho lemala ka ho toba moeeng, dysrhythmias, epistaxis, esophageal intubation, hypotension, hypoxia, iatrogenic blood, laryngoscope failure, laryngospasm, lip laceration, main-stem bronchus intubation, malignant hyperthermia. phoso ea meriana, pharyngeal laceration, pneumothorax, endotracheal tube cuff failure, le ho hlatsa).

Re entse tlhahlobo ea subgroup e hlophisitsoeng ka lethal dose e thehiloeng ho boima ba 'mele.

Results

Ho ne ho e-na le 2,275 li-intubations tse latellanang ka potlako e tataisoa ke succinylcholine le 1,800 ke rocuronium. Bakuli ba fumanang succinylcholine ba ne ba le monyane ba bile ba le maemong a ho feta ka ts'ebetso ea laryngoscopy ea video le ke bafani ba nang le boiphihlelo ba eketsehileng.

Tekanyo ea katleho ea pele-pele e ne e le 87.0% ka tekanyo ea succinylcholine ha e bapisoa le 87.5% e nang le rocuronium (tekanyetso e fetotsoeng ea likhakanyo tsa 0.9; 95% nako ea kholiseho 0.6 ho ea ho 1.3). Keketseho ea ketsahalo efe kapa efe e mpe e ne e boetse e bapisoa pakeng tsa liakhente tsena: 14.7% bakeng sa ancinylcholine bapisoa le 14.8% bakeng sa rocuronium (tekanyetso e fetotsoeng ea karo-karo ea 1.1; 95% nako ea kholiseho ea 0.9 ho ea ho 1.3). Re hlokometse liphetho tse tšoanang ha ba ne ba aroloa ka litekanyetso tsa boima ba 'mele tse amanang le boima ba' mele.

fihlela qeto e

Lenaneong lena le leholo la ho shebella, ha re a ka ra bona setsoalle pakeng tsa khetho ea ho shoella le katleho e potlakileng ea tatellano kapa liketsahalo tse bohloko tsa ho kenella ka nako ea pente.

bangodi

• • Michael D. April, MD, DPhil
  • Allyson Arana, PhD
  • Daniel J. Pallin, MD, MPH
  • Steven G. Schauer, DO, MS
    
  • Andrea Fantegrossi, MPH
  • Jessie Fernandez, BS
  • Joseph K. Maddry, MD
  • Shane M. Summers, MD
  • Mark A. Antonacci, MD