etomidate + succinylcholine

Etomidate + succinylcholine is a combination regimen commonly used for rapid sequence intubation (RSI) in emergency and critical care settings. Etomidate is a short-acting intravenous anesthetic agent that acts as a non-barbiturate hypnotic, providing rapid sedation without analgesia by enhancing the effects of gamma-aminobutyric acid (GABA) at GABA-A receptors. It is favored for its stable hemodynamic profile and minimal cardiovascular depression[4][6]. Succinylcholine is a depolarizing neuromuscular blocker that induces skeletal muscle paralysis by binding to nicotinic acetylcholine receptors at the neuromuscular junction, causing persistent depolarization and subsequent muscle relaxation[5][7]. This combination allows for quick induction of unconsciousness (via etomidate) followed by rapid onset paralysis (via succinylcholine), facilitating endotracheal intubation. Etomidate has an onset of action within one minute and duration of three to five minutes; succinylcholine acts within 30–60 seconds with effects lasting about 5–15 minutes[6][7]. The regimen does not provide analgesia or amnesia beyond hypnosis, so additional agents may be required depending on clinical context.