A review article in Anesthesia and Analgesia provides a summary of the literature surrounding RSI controversies.

• Should a pre-determined dose of induction drug be given or should it be titrated to effect prior to giving suxamethonium?
• Should fast acting opioids be coadministered to blunt the pressor response?
• What is the optimal dose of suxamethonium?
• Should defasciculating doses of neuromuscular blocking drugs be given?
• What is the ‘priming’ technique with rocuronium and is it necessary?
• Is it really bad to bag-mask ventilate the patient after induction prior to intubation? Which patients might this benefit?
• Should patients with full stomachs be anaesthetised sitting up, supine, or head down?
• Is cricoid pressure a good or a bad thing?

Not surprisingly the jury is still out on these, which is of course why they remain ‘controversies’. The review article provides a readable, interesting, and up to date summary of the evidence to date.

Rapid Sequence Induction and Intubation: Current Controversy
Anesth Analg. 2010 May 110(5):1318-25