International Journal of Clinical Research

Objective To evaluate the safety and efficacy of rapid sequential induction anesthesia in emergency patients with gastrointestinal perforation complicated by shock. Methods A total of 48 patients with gastrointestinal perforation complicated by shock admitted to the emergency department of our hospital from January 2023 to June 2025 were selected as the study subjects. They were divided into a rapid sequential induction group (n=24) and a traditional induction group (n=24) based on the anesthesia induction method. The rapid sequential induction group underwent sequential induction with remifentanil 5 mg, cis-atracurium 10 mg, and etomidate 10-12 mg, while the traditional induction group received a conventional rapid induction protocol. The hemodynamic stability during anesthesia induction, intubation conditions, intraoperative hemodynamic changes, and postoperative recovery were compared between the two groups. Results In the rapid sequential induction group, the decrease in mean arterial pressure after anesthesia induction was significantly smaller than that in the traditional induction group, and the change in heart rate was less pronounced. The excellent rate of intubation conditions in the rapid sequential induction group was significantly higher than that in the traditional induction group, and the use of vasoactive drugs during surgery was lower. The postoperative recovery time was significantly shorter in the rapid sequential induction group compared to the traditional induction group, and the incidence of postoperative nausea and vomiting was lower. Conclusion Rapid sequential induction anesthesia provides better hemodynamic stability and safety in emergency patients with gastrointestinal perforation complicated by shock, which is beneficial for improving patient prognosis.

Rapid sequential induction; Gastrointestinal perforation; Anesthesia safety