Remifentanil inferior to neuromuscular blockers for successful tracheal intubation in adults at risk of aspiration

• The researchers measured the primary outcome as successful tracheal intubation without major complications (in the first attempt).
• The successful intubation on the first attempt occurred in 374 out of 575 patients, constituting 66.1 % receiving Remifentanil.
• Among patients receiving Neuromuscular blockers, 408 out of 575 patients constituting 71.6 %, had successful intubation on the first attempt.
• Remifentanil was inferior to neuromuscular blockers. The adjusted between-group difference was –6.1%.
• Nineteen patients with Remifentanil and 3 with neuromuscular blockers had hemodynamic instability with an adjusted difference of 2.8%.

To conclude, as per the study's findings, Remifentanil was inferior to neuromuscular blockers in the rate of successful tracheal intubation without major complications.

Further reading:

Grillot N et al. 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. JAMA. 2023;329(1):28–38. doi:10.1001/jama.2022.23550