title: Optimal dose of succinylcholine for tracheal intubation in patients during inhalation induction with sevoflurane: a randomized controlled trial.
abstract: OBJECTIVE
  To determine the dose of succinylcholine during inhalation induction of a patient.
  
  
  METHODS
  Prospective, double-blind, randomized study.
  
  
  METHODS
  Operating room of a university hospital.
  
  
  METHODS
  180 adult, ASA physical status 1 and 2 patients with a suspected difficult airway, who were scheduled for surgery.
  
  
  METHODS
  Nonpremedicated patients were anesthetized with inhalation of 8% sevoflurane, followed by succinylcholine. Group 1 received intravenous (IV) succinylcholine 0.3 mg/kg, Group 2 had IV succinylcholine 0.6 mg/kg, and Group 3 was given IV succinylcholine 1.0 mg/kg. Direct laryngoscopy and tracheal intubation were performed after onset of succinylcholine.
  
  
  METHODS
  Intubation conditions were scored as excellent, good, or poor. The recovery time of spontaneous respiration, end-tidal carbon dioxide partial pressure (PETCO2), and pulse oxygen saturation (SpO2) were recorded.
  
  
  RESULTS
  Acceptable conditions (excellent and good) for intubation were rated in 80% of Group 1 patients (0.3 mg/kg succhinylcholine), 91.7% of Group 2 patients (0.6 mg/kg), and 93.3% of Group 3 patients (1.0 mg/kg), respectively. Intubation scores were similar in Groups 2 and 3, and were significantly higher than in Group 1 patients (0.3 mg; P < 0.01). Time to recovery of spontaneous respiration in Group 3 was significantly prolonged compared with Groups 1 and 2 (238 ± 59 sec vs 132 ± 43 sec, P < 0.001; 238 ± 59 sec vs 151 ± 47 sec, P < 0.001, respectively). SpO2 in Group 3 did not differ significantly from Group 1 and 2 values. However, PETCO2 in Group 3 was significantly higher than in Groups 1 or 2.
  
  
  CONCLUSIONS
  Succinylcholine at a dose of 0.6 mg/kg IV provided intubation conditions similar to succinylcholine at 1.0 mg/kg IV, and recovery of spontaneous respiration following a 0.6 mg/kg dose of succinylcholine was significantly shorter.
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China; Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
authors.forename: Lin-Li
authors.initials: LL
authors.lastname: Luo
authors.affiliation: Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P. R. China.
authors.forename: Liang-Xue
authors.initials: LX
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China. Electronic address: J-wang@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China.
authors.forename: Ping
authors.initials: P
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D002245:Carbon Dioxide / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011446:Prospective Studies; D012119:Respiration; D000077149:Sevoflurane; D013390:Succinylcholine / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D009467:Neuromuscular Depolarizing Agents; D002245:Carbon Dioxide; D000077149:Sevoflurane; D013390:Succinylcholine; D010100:Oxygen
keywords: Difficult airway; Recovery; Sevoflurane; Spontaneous respiration; Succinylcholine; Tracheal intubation conditions