Application of rapid induction of intubation by sedatives combined with cis-atracurium in the emergency department

Objective To study the effect of sedative combined with cis-atracurium in rapid induction intubation in emergency department. Methods From October 15, 2017 to April 15, 2019, 52 critically ill patients who needed tracheal intubation in emergency department of the People's Hospital of Changzhi were selected.And the patients were numbered according to the time sequence of enrollment, and then randomly divided into group A and group B according to the random number table, with 26 cases in each group.Group A was given sedatives combined with cis-atracurium to induce rapid intubation.Group B only received sedatives to induce intubation.The success rate of intubation, successful intubation time were compared between the two groups.Before and after endotracheal intubation, the heart rate, mean arterial blood pressure, pulse oxygen concentration and the change of catecholamine concentration were compared. Results The success rate of intubation in group A was 100.0%, which in group B was 76.9%, the difference between the two groups was statistically significant (χ2=12.15, P 0.05). The serum adrenaline level was higher compared with before intubation, but there was no statistically significant difference (t=-1.03, P>0.05). In group B, the pulse oxygen concentration was significantly increased after intubation compared with before intubation (t=5.74, P 0.05). Conclusion In the airway management of critically ill patients in emergency department, the application of sedatives combined with cis-atracurium to rapidly induce intubation can improve the hypoxia symptoms of patients more rapidly and can keep patients' hemodynamics, catecholamine concentration is relatively stable, it has the characteristics of safety and efficiency. Key words: Emergency service, hospital; Emergencies; Critical illness; Airway management; Intubation, intratracheal; Atracurium; Hypnotics and sedatives; Hemodynamics