Frequency of haemoglobin desaturation with the use of succinylcholine during rapid sequence induction of anaesthesia.
BACKGROUND
The perceived safety of the use of succinylcholine is based on the fact that recovery from its effects will occur before oxygen desaturation occurs in case of failure to intubate or ventilate. The purpose of this study was to examine the incidence of oxygen desaturation after the use of succinylcholine prior to resumption of spontaneous ventilation following four different preoxygenation techniques.


METHODS
Twenty-five patients each were randomly allocated to preoxygenation with 4 deep breaths of 100% oxygen or by breathing oxygen for 1, 3 or 5 min following which they received a rapid sequence induction of anaesthesia with fentanyl 1 microg kg(-1), a sleep dose of thiopentone and succinylcholine 1 mg kg(-1). Oxygen saturation was monitored continuously using a finger probe. Ventilation was not assisted unless the saturation decreased to <or=90%.


RESULTS
Eleven out of the 100 patients had a decrease in their oxygen saturation to <or=90% before the resumption of effective spontaneous ventilation irrespective of the technique of preoxygenation.


CONCLUSIONS
We conclude that use of succinylcholine may not always prevent desaturation if there is a failure to intubate and ventilate during a rapid sequence induction of anaesthesia.
Hayes
A H
AH
Department of Anaesthetics and Intensive Care Medicine, The Queen's University of Belfast, Northern Ireland, UK.
Breslin
D S
DS
Mirakhur
R K
RK
Reid
J E
JE
O'Hare
R A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia; D001785:Blood Gas Monitoring, Transcutaneous; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects*; D010100:Oxygen / Q000097:blood; D013390:Succinylcholine / Q000009:adverse effects*
D006454:Hemoglobins; D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine; D010100:Oxygen