The decline is Succinylcholine use has been expedited by the arrival of Sugammadex. Succinylcholine is often still preferred where the risk of aspiration is deemed higher.
This study compared rapid sequence induction (RSI) with modified rapid sequence induction (mRSI) in infants.
The conclusion found mRSI acceptable practice: “In infants presenting for pyloromyotomy, anesthetic induction with mRSI compared with RSI was associated with significantly less hypoxemia without an observed increase in aspiration events. In addition, the need for multiple intubation attempts was a strong predictor of hypoxemia. The increased risk of hypoxemia associated with RSI and multiple intubation attempts was even more pronounced in neonatal patients.”