title: The dose of succinylcholine required for excellent endotracheal intubating conditions.
abstract: 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 microg/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.
authors.affiliation: Department of Anesthesiology and Pain Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030-4009, USA. naguib@mdanderson.org
authors.forename: Mohamed
authors.initials: M
authors.lastname: Naguib
authors.forename: Abdulhamid H
authors.initials: AH
authors.lastname: Samarkandi
authors.forename: Mansour Emad
authors.initials: ME
authors.lastname: El-Din
authors.forename: Khaled
authors.initials: K
authors.lastname: Abdullah
authors.forename: Mazen
authors.initials: M
authors.lastname: Khaled
authors.forename: Saleh W
authors.initials: SW
authors.lastname: Alharby
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods* / Q000592:standards; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013390:Succinylcholine / Q000008:administration & dosage* / Q000592:standards; D013997:Time Factors
chemical_list: D013390:Succinylcholine