Newer agents for rapid sequence intubation: Etomidate and rocuronium Review uri icon


MeSH Major

  • Androstanols
  • Anesthetics, Intravenous
  • Etomidate
  • Intubation, Intratracheal
  • Neuromuscular Nondepolarizing Agents
  • Premedication


  • The emergency airway management of children and adolescents with critical illnesses may necessitate rapid sequence intubation with a sedating and a neuromuscular blocking agent. Etomidate and rocuronium have become increasingly popular for the sedation and paralysis, respectively, of pediatric patients in rapid sequence intubation, and there are many advantages to the use of both agents. Both etomidate and rocuronium have a rapid onset of action, and both agents are relatively free of hemodynamic adverse effects. Etomidate does, however, suppress adrenal function, and consequently, its use in patients with septic shock is controversial. Rocuronium can produce optimal intubating conditions without the serious complications that can accompany succinylcholine. The available evidence supports the safety of etomidate and rocuronium in rapid sequence intubation but also suggests that more prospective studies are needed in pediatric patients.

publication date

  • March 2009



  • Review



  • eng

Digital Object Identifier (DOI)

  • 10.1097/PEC.0b013e31819a8bbf

PubMed ID

  • 19287283

Additional Document Info

start page

  • 200

end page

  • 7; quiz 208-10


  • 25


  • 3