Anesthesia & Analgesia

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Anesthesia & Analgesia:
doi: 10.1213/01.ANE.0000181320.88283.BE
Anesthetic Pharmacology: Research Report

The Dose of Succinylcholine Required for Excellent Endotracheal Intubating Conditions

Naguib, Mohamed MB, BCh, MSc, MD; Samarkandi, Abdulhamid H. MB, BS, KSUF, FFARCSI; El-Din, Mansour Emad MD; Abdullah, Khaled MB, BCh, MSc, AB, MD; Khaled, Mazen MD; Alharby, Saleh W. MB, BS, FRCS (Glas)

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In this prospective, randomized, double-blind, placebo-controlled study, we attempted to define the dose of succinylcholine that provides excellent intubation conditions in patients within 60 s during simulated rapid-sequence induction of anesthesia. Anesthesia was induced in 180 patients with 2 μg/kg fentanyl and 2 mg/kg propofol. After loss of consciousness, patients were randomly allocated to receive 0.3, 0.5, 1.0, 1.5, or 2.0 mg/kg succinylcholine or saline solution (control group). Tracheal intubation was performed 60 s later. A blinded investigator performed all laryngoscopies and graded intubating conditions. Intubating conditions were excellent in 0.0%, 43.3%, 60.0%, 63.3%, 80.0%, and 86.7% of patients after 0.0, 0.3, 0.5, 1.0, 1.5, and 2.0 mg/kg succinylcholine, respectively. The incidence of excellent intubating conditions was significantly more frequent (P < 0.001) in patients receiving succinylcholine than in the controls and in patients who received 2.0 mg/kg succinylcholine (P < 0.05) than in those who received 0.3 mg/kg succinylcholine. The calculated doses of succinylcholine (and their 95% confidence intervals) that are required to achieve excellent intubating conditions in 50% and 80% of patients at 60 s are 0.39 (0.29–0.51) mg/kg and 1.6 (1.2–2.0) mg/kg, respectively. It appears that there are no advantages to using doses of succinylcholine larger than 1.5 mg/kg.

© 2006 International Anesthesia Research Society

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