title: Desaturation following rapid sequence induction using succinylcholine vs. rocuronium in overweight patients.
abstract: BACKGROUND
  Rapid sequence induction may be associated with hypoxemia. The purpose of this study was to investigate the possible difference in desaturation during rapid sequence induction in overweight patients using either succinylcholine or rocuronium.
  
  
  METHODS
  Sixty patients with a body mass index (BMI) between 25 and 30 kg/m², American Society of Anesthesiologists class I or II, undergoing general anesthesia were randomly divided into a succinylcholine group and a rocuronium group. After a 3-min preoxygenation, patients received rapid sequence induction of general anesthesia with midazolum-fentanyl-propofol and succinylcholine (1.5 mg/kg) or rocuronium (0.9 mg/kg). Ventilation was not initiated until oxygen saturation declined to 92%. We measured the times when oxygen saturation reached 98%, 96%, 94% and 92%. Safe Apnea Time was defined as the time from administration of neuromuscular blocking drugs to oxygen saturation fell to 92%. The recovery period was defined as the time from initiation of ventilation until oxygen saturation was 97%. Arterial blood gases were taken at baseline, after preoxygenation and at 92% oxygen saturation.
  
  
  RESULTS
  The mean Safe Apnea Time (95% CI) was 283 (257-309) s in succinylcholine vs. 329 (303-356) s in rocuronium (P=0.01). The mean recovery period (95% CI) was 43 (39-48) s in succinylcholine vs. 36 (33-38) s in rocuronium (P=0.002). Blood gas analysis showed no difference between the two groups.
  
  
  CONCLUSIONS
  Succinylcholine was associated with a significantly more rapid desaturation and longer recovery of oxygen saturation than rocuronium during rapid sequence induction in overweight patients.
authors.affiliation: Department of Anesthesiology, Shanghai First People's Hospital, Shanghai Jiaotong University, China.
authors.forename: L
authors.initials: L
authors.lastname: Tang
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: S
authors.initials: S
authors.lastname: Huang
authors.forename: H
authors.initials: H
authors.lastname: Ma
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000732:Androstanols; D000768:Anesthesia, General; D001049:Apnea / Q000503:physiopathology; D001784:Blood Gas Analysis; D015992:Body Mass Index; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008874:Midazolam; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D050177:Overweight / Q000503:physiopathology*; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D000077123:Rocuronium; D013390:Succinylcholine; D055815:Young Adult
chemical_list: D000732:Androstanols; D006993:Hypnotics and Sedatives; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D013390:Succinylcholine; D008874:Midazolam; D010100:Oxygen; D000077123:Rocuronium