The use of mini-dose suxamethonium to facilitate the insertion of a laryngeal mask airway.
The use of mini-dose suxamethonium to facilitate the insertion of a laryngeal mask airway was investigated. Sixty patients were assigned randomly in a double-blind manner to receive 0.9% sodium chloride or suxamethonium 0.1 mg.kg-1 intravenously, following intravenous induction with propofol 2.5 mg.kg-1. The laryngeal mask was inserted after the first attempt in 87% of patients. Mini-dose suxamethonium improved the correct positioning of the laryngeal mask during the first attempt (93 vs. 67%, p < 0.02), decreased the incidence of swallowing (p < 0.001), gagging (p < 0.001) and head or limb movement (p < 0.05). Laryngeal mask insertion was graded as easy in 93% of patients who had mini-dose suxamethonium, compared with 60% in the placebo group (p < 0.01). The duration of apnoea between the two groups was not significantly different (0.54 vs. 0.61 min, p = 0. 46). The total dose of propofol needed to insert the laryngeal mask was lower in the suxamethonium group (2.57 vs. 3.25 mg.kg-1, p < 0. 01) and was associated with less hypotension (p < 0.05). Fasciculation (17%) and mild myalgia (23%) were common despite the small dose of suxamethonium used. In conclusion, mini-dose suxamethonium facilitates laryngeal mask insertion. Myalgia is common and the technique is not recommended for patients who are prone to suxamethonium myalgia.
Senior Medical Officer, Department of Anaesthesia and Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China.
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D010919:Placebos; D015742:Propofol; D012965:Sodium Chloride; D013390:Succinylcholine / Q000008:administration & dosage*
D009467:Neuromuscular Depolarizing Agents; D010919:Placebos; D012965:Sodium Chloride; D013390:Succinylcholine; D015742:Propofol