In the April 2012 BJA ...

British Journal of Anaesthesia

PubMedID: 22419639

The introduction of sugammadex to clinical practice has potentially given us an alternative to suxamethonium for rapid sequence intubation (RSI). Two contrasting aspects of this are presented in this month's issue. A randomized comparison of suxamethonium and rocuronium for RSI found that return to spontaneous ventilation occurred more quickly in the group who received rocuronium then immediate reversal with sugammadex than in the suxamethonium group (Sørensen et al., pages 682–9). However, a cautionary note is raised in a case report describing the use of sugammadex in a ‘can't intubate, can't ventilate’ (CICV) situation in a patient with a difficult airway given rocuronium (Curtis et al., pages 612–14). Repeated intubation attempts resulted in CICV and although sugammadex reversed the …