Munir Ahmad, Nadeem Ahmad Khan, Aamir Furqan


Background: To compare outcomes of different doses of succinylcholine, in terms of intubation condition, onset of action, duration of action and abdominal fasciculation. Methods: Thus randomized control trial was conducted in the department of anaesthesia and ICU, Nishter Hospital Multan from April 2016 to November 2016. A total number of 60 patients with ASA status I and II were enrolled. All patients were divided into three groups by lottery method. Data was entered and analysed by computer software SPSS version 23.2. Descriptive variables like age and onset of action were presented as mean and SD and continues statistics like gender, abdominal fasciculation and incubation condition were presented as frequency and percentages. Chi square test and one-way ANOVA was applied to see effect modification and significance of results. The p-value 0.05 was considered as significant. Results: A Total number of 60 patients included in this study and all were female. The mean age of the patients was 28.15±4.5 years. The main outcome variables of this study were the fasciculation, satisfactory intubation, onset time (seconds) and duration of action (in minutes). In group (A) 1mg, Abdominal fasciculation was found 80%, 85% and 75% in group A, B, C respectively. It was also observed that satisfactory intubation was found 90%, 80% and 30% in three groups respectively. The mean onset time was 50.95±4.6, 70.7±5.66 and 94.15±8.73 seconds in three groups respectively. Similarly, the mean duration of action was 16.1±3.76, 13.55±3.01 and 8±2.05 minutes respectively. Conclusion: Results of our clinical trial suggest that succinylcholine in low doses shorter duration of action and low rate of abdominal fasciculation which is desirable for rapid induction but onset of action is prolonged and intubation conditions were not satisfactory predominantly. So, we concluded that low doses of succnylcholine are not so much beneficial that I can replace full doses of succinylcholine when used for rapid induction and intubation.

Keywords: Succinylcholine, Rapid induction, Intubation, Anaesthesia

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Girard T. Pro: rocuronium should replace succinylcholine for rapid sequence induction. Eur J Anaesthesiol 2013;30(10):585–9.

Sorbello M. Muscle relaxants and intubation: what has changed in the last 500 years. Seventh annual spring scientific symposium in anethesiology and intensive care; 2015.

Kadoi Y, Hoshi H, Nishida A, Saito S. Comparison of recovery times from rocuronium-induced muscle relaxation after reversal with three different doses of sugammadex and succinylcholine during electroconvulsive therapy. J Anesth 2011;25(6):855–9.

Martin-Flores M. Neuromuscular blocking agents and monitoring in the equine patient. Vet Clin North Am Equine Pract 2013;29(1):131–54.

Nightingale C, Cousins J, Fox W, Gabbott D, Griffiths R, Kennedy N, et al. Guidelines on Managing the Obese Surgical Patient Joint document from AAGBI and SOBA. AAGBI London; 2014.

Smith CE, Donati F, Bevan DR. Dose-response curves for succinylcholine: single versus cumulative techniques. Anesthesiology 1988;69(3):338–42.

Kopman AF, Klewicka MM, Neuman GG. An alternate method for estimating the dose-response relationships of neuromuscular blocking drugs. Anesth Analg 2000;90(5):1191–7.

Naguib M, Samarkandi A, Riad W, Alharby SW. Optimal dose of succinylcholine revisited. Anesthesiology 2003;99(5):1045–9.

Chan JK, Ng I, Ang JP, Koh SM, Lee K, Mezzavia P, et al. Randomised controlled trial comparing the Ambu® aScope™ 2 with a conventional fibreoptic bronchoscope in orotracheal intubation of anaesthetised adult patients. Anaesth Intensive Care 2015;43(4):479–84.

Biro P, Ruetzler K. The reflective intubation manoeuvre increases success rate in moderately difficult direct laryngoscopy: A prospective case–control study. Eur J Anaesthesiol 2015;32(6):406–10.

Panhuizen IF, Snoeck MM, Levano S, Girard T. Prolonged neuromuscular blockade following succinylcholine administration to a patient with a reduced butyrylcholinesterase activity. Case Rep Med 2010;2010:472389.

McGillicuddy DC, de La Pena J, Goudie JS, Fisher J, Shapiro N, Sanchez LD. Adherence to dose of succinylcholine and etomidate in the emergency department. West J Emerg Med 2010;11(5):432–4.

Dhonneur G, Kirov K, Slavov V, Duvaldestin P. Effects of an Intubating Dose of Succinylcholine and Rocuronium on the Larynx and Diaphragm An Electromyographic Study in Humans. Anesthesiology 1999;90(4):951–5.

Fox CJ, Kaye AD, Hummel JC, Sidransky M. Perioperative Pediatric Anesthesia Trauma Considerations. In: Anesthesia for Trauma: Springer, 2014; p.321–33.

El-Subbagh HI, El-Azab AS, Hassan GS, El-Messery SM, Abdel-Aziz AA, El-Taher KEH. Thiadiazolodiazepine analogues as a new class of neuromuscular blocking agents: Synthesis, biological evaluation and molecular modeling study. Eur J Med Chem 2017;126:15–23.

Kalow W, Gunn D. The relation between dose of succinylcholine and duration of apnea in man. Surv Anesthesiol 1958;2(5):452.

Lewis SL, Maltas J, Dirksen SR, Bucher L. Study guide for medical-surgical nursing: Assessment and management of clinical problems: Elsevier Health Sciences; 2015.

Newton R, Hack H. Place of rapid sequence induction in paediatric anaesthesia. BJA Educ 2016;16(4):120–3.

Blobner M, Mirakhur RK, Wierda JM, Wright PM, Olkkola KT, Debaene B, et al. Rapacuronium 2.0 or 2.5 mg kg–1 for rapid‐sequence induction: comparison with succinylcholine 1.0 mg kg–1. Br J Anaesth 2000;85(5):724–31.

Andrews JI, Kumar N, van den Brom RH, Olkkola KT, Roest G, Wright PM. A large simple randomized trial of rocuronium versus succinylcholine in rapid‐sequence induction of anaesthesia along with propofol. Acta Anaesthesiol Scand 1999;43(1):4–8.

Sparr HJ, Mellinghoff H, Blobner M, Noldge-Schomburg G. Comparison of intubating conditions after rapacuronium (Org 9487) and succinylcholine following rapid sequence induction in adult patients. Br J Anaesth 1999;82(4):537–41.


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