Effectiveness and sequelae of very low-dose suxamethonium for nasal intubation

Nimmo, Susan; McCann, N; Broome, I. J.; Robb, H.

doi:10.1093/bja/74.1.31

Cited by 24 publications

(25 citation statements)

References 15 publications

(17 reference statements)

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“…Intravenous succinylcholine, in a dose of small as 0.1 mg/kg had been found to be reliable in the treatment of laryngeal spasm. 6 Although succinylcholine has commonly been employed in low doses in combination with other induction agents for the insertion of LMAs, potential problems such as masseter muscle spasm, prolonged apnoea, myalgia, hyperkalemia and inadvertent administration to patients with pseudocholinesterase deficiency or malignant hyperthermia may occur. 14,15 These were not problems that were encountered in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Nimmo and colleagues suggested that this adverse reactions can be avoided by reducing the doses of succinylcholine substantially. 6 Previous studies had proven the usefulness of mini-dose succinylcholine (0.1mg/kg) for insertion of LMA without significant patient reaction under propofol anaesthesia in patients coming for elective short surgical procedures. 6 In our study we have compared two small doses of succinylcholine (0.1mg/kg and 0.2mg/kg) to assess the ease of LMA insertion.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of two doses of succinylcholine to facilitate the Laryngeal mask airway insertion under propofol anaesthesia in adult patients undergoing elective minor surgical procedures

Gunaseelan

Prabu

2017

Asian J Med Sci

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Background: Small dose of succinylcholine combined with propofol facilitates Laryngeal mask airway (LMA) insertion. This study was designed to compare the efficacy of two different small doses of succinylcholine for LMA insertion. Aims and Objectives: The aim of our study is to compare the usefulness of two different doses of succinylcholine to facilitate the insertion of laryngeal mask airway under intravenous anaesthesia. Material and Methods: Seventy patients of ASA I and II posted for elective day care procedure under general anaesthesia with Laryngeal mask airway (LMA) were randomly allocated into two groups of 35 each. 35 patients in group PS1 received Inj. propofol 2.0 mg/kg + succinylcholine 0.1 mg/kg (diluted to 2 ml). 35 patients in group PS2 received Inj. propofol 2.0 ml/kg + succinylcholine 0.2 mg/kg (diluted to 2 ml). During insertion of laryngeal mask airway jaw relaxation, gagging/coughing, head and limb movements, presence or absence of laryngospasm and duration of apnoea were noted. Results: Patients in PS2 had better conditions for LMA insertion, reduced the upper airway responses to the LMA insertion, and reduced the supplement doses of propofol compared to PS1. Conclusion: Succinylcholine in 0.2 mg/kg compared to 0.1kg provides optimal conditions for LMA insertion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of two doses of succinylcholine to facilitate the Laryngeal mask airway insertion under propofol anaesthesia in adult patients undergoing elective minor surgical procedures

Gunaseelan

Prabu

2017

Asian J Med Sci

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“…[410–12] Stewart et al . [11] reported that 26 (96%) of 27 patients receiving 1.5 mg/ kg succinylcholine and 30 (94%) of 32 patients receiving 0.5 mg/kg had acceptable intubating conditions.…”

Section: Discussionmentioning

confidence: 99%

Intubating conditions following rapid sequence induction with three doses of succinylcholine

et al. 2012

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Background:The aim of this prospective, randomized, double-blind study was to compare tracheal intubating conditions and the duration of apnoea following administration of 0.4, 0.6 and 1.0 mg/kg of succinylcholine during simulated rapid sequence induction of anaesthesia.Methods:Anaesthesia was induced with fentanyl 2 μg/kg and propofol 2 mg/kg followed by application of cricoid pressure. Patients were randomly allocated to three groups according to the dose of succinylcholine administered (0.4, 0.6 or 1.0 mg/kg). Intubating conditions were assessed at 60 s after succinylcholine administration. Time to first diaphragmatic contraction (apnoea time) and time to resumption of regular spontaneous breathing were noted.Results:Excellent intubating conditions were obtained in 52.4%, 95.7% and 100% of the patients after 0.4, 0.6 and 1.0 mg/kg succinylcholine, respectively; P<0.001. Acceptable intubating conditions (excellent and good grade combined) were obtained in 66.7%, 100% and 100% of the patients after 0.4, 0.6 and 1.0 mg/ kg succinylcholine, respectively; P<0.001. Apnoea time and resumption of regular spontaneous breathing were dose-dependent. Apnoea time was 3.8±1.1 min, 4.3±0.9 min and 8.2±3.4 min in groups 0.4, 0.6 and 1.0 mg/kg, respectively; P<0.001. Time to regular spontaneous breathing was 5.3±1.2 min, 5.5±1.1 min and 8.9±3.5 min in groups 0.4, 0.6 and 1.0 mg/kg, respectively; P<0.001.Conclusion:A dose of 0.6 mg/kg succinylcholine can be used for rapid sequence induction of anaesthesia as it provides acceptable intubating conditions with a shorter apnoea time compared with a dose of 1 mg/kg.

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“…Overall insertion condition was assessed by modified scheme of grading of intubation conditions by Lund and Stovner 4 . Incidence of gagging or coughing on insertion was scored on a four point scale according to Nimmo and collegues 5 . Incidence of laryngospasm and other complication was also noted.…”

Section: Methodsmentioning

confidence: 99%

Comparative Study of Propofol Versus Thiopental Sodium with Succinylcholine for Laryngeal Mask Airway (LMA) Insertion

Karmakar

Rahman²,

Karim

et al. 2018

J Shaheed Suhrawardy Med Coll

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Background: The increasing emphasis on day case anaesthesia has lead to the greater use of the laryngeal mask airway (LMA) as an alternative to intubation. Laryngoscopy and tracheal intubation are noxious stimuli, which cause a reflex increase in both sympathetic and sympathoadrenal activity that may result in tachycardia, hypertension and dysarrhythmias. Insertion of Laryngeal mask airway (LMA) is associated with less haemodynamic changes, minimal increase in intraocular and intracranial pressure and lower incidence of sore throat. Still its insertion requires sufficient depth of anesthesia to prevent airway reflex (gagging, coughing nd spasms). To insert LMA successfully propofol is the most frequently administered medication. But most of all recommend not using propofol singly for LMA insertion. Thiopental can’t suppress the upper airway reflexes as propofol but with low dose succinylcholine upper airway reflexes are attenuated so combination of thiopental sodium with succinylcholine may be another choice of drug.Objectives: This Prospective study was conducted to evaluate the effectiveness of Thiopental sodium and Succinylcholine for insertion of the LMA in comparison with Propofol.Methods: This interventional study was carried out in Sixty patients, aged 3-45 years who were scheduled for elective surgical procedure under general anaesthesia in ShSMCH. Patients were randomly assigned to two groups by odd and even number basis. In Group-1 (N1=30), LMA was inserted after induction with Thiopental sodium (5 mg/kg body weight i.v.) and Succinylcholine (0.5mg/kg i.v); in Group-2 (N2 = 30), the LMA was inserted with Propofol (2.5mg/kg i.v). Jaw relaxation, incidence of coughing- gagging , overall insertion condition and haemodynamic changes were observed.Results: Grade of jaw relaxation in Group-1 was Good in 93.3%, incomplete in 6.7% and 0% poor but in Group-2, 86.7% was good 10% incomplete and 3.3% was poor. Coughing occurred in 33.3% of patients in the Group-2 and there was only 10% in succinyl group (P=0.028) which is significantly higher in Group-2. Overall insertion condition in Group -1 was excellent in 86.7%, Good in 10% cases and poor in only 3.3% cases on the other hand in Group-2 excellent in 53.3%, Good in 33.3% cases and poor in only 13.3% cases (P=0.019).Conclusion: There was statistically significant difference in jaw relaxation in two groups and incidence of Gagging or Coughing is higher in Group-2. Overall insertion condition was significantly better in Group-1. We concluded that Thiopental sodium with low dose Suxamethonium is an effective alternative of Propofol.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 11-15

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Effectiveness and sequelae of very low-dose suxamethonium for nasal intubation

Cited by 24 publications

References 15 publications

Comparison of two doses of succinylcholine to facilitate the Laryngeal mask airway insertion under propofol anaesthesia in adult patients undergoing elective minor surgical procedures

Comparison of two doses of succinylcholine to facilitate the Laryngeal mask airway insertion under propofol anaesthesia in adult patients undergoing elective minor surgical procedures

Intubating conditions following rapid sequence induction with three doses of succinylcholine

Comparative Study of Propofol Versus Thiopental Sodium with Succinylcholine for Laryngeal Mask Airway (LMA) Insertion

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