Editing Rapid sequence induction (section)

==== Paralysis with induction ====
With standard intravenous induction of general anesthesia, the patient typically receives an [[opioid]], and then a hypnotic medication. Generally the patient will be manually ventilated for a short period of time before a [[neuromuscular block]]ing agent is administered and the patient is intubated. During rapid sequence induction, the person still receives an IV opioid. However, the difference lies in the fact that the induction drug and neuromuscular blocking agent are administered in rapid succession with no time allowed for manual ventilation.{{citation needed|date=January 2022}}

Commonly used hypnotics include [[Sodium thiopental|thiopental]], [[Propofol]] and [[etomidate]]. The [[Neuromuscular-blocking drug|neuromuscular blocking agents]] paralyze all of the [[Skeletal striated muscle|skeletal muscles]], most notably and importantly in the [[oropharynx]], [[larynx]], and [[Thoracic diaphragm|diaphragm]]. [[Opioid]]s such as [[fentanyl]] may be given to attenuate the responses to the intubation process ([[tachycardia|accelerated heart rate]] and increased [[intracranial pressure]]). This is supposed to have advantages in patients with [[Ischaemic heart disease|ischemic heart disease]] and those with [[brain injury]] (e.g. after [[traumatic brain injury]] or [[stroke]]). [[Lidocaine]] is also theorized to blunt a rise in intracranial pressure during laryngoscopy, although this remains controversial and its use varies greatly. Atropine may be used to prevent a reflex bradycardia from vagal stimulation during laryngoscopy, especially in young children and infants. Despite their common use, such adjunctive medications have not been demonstrated to improve outcomes.<ref name=Neilipovitz2007>{{cite journal | vauthors = Neilipovitz DT, Crosby ET | title = No evidence for decreased incidence of aspiration after rapid sequence induction | journal = Canadian Journal of Anaesthesia | volume = 54 | issue = 9 | pages = 748–764 | date = September 2007 | pmid = 17766743 | doi = 10.1007/BF03026872 | doi-access = free }}</ref>