Comparative evaluation of low dose succinylcholine against standard intubating dose in children

A. P. Ellango, H. M. Krishna, Gurudas Kini

Research output: Contribution to journalArticle

Abstract

Background : Critical oxyhaemoglobin desaturation can occur if ventilation is unassisted with the conventional intubation dose of 1.0mgkg-1 succinylcholine. We conducted this study to evaluate the role of low dose succinylcholine in producing acceptable intubating conditions during rapid tracheal intubation in paediatric patients and whether it leads to a lesser duration of apnoea. Patients & Methods: After IRB approval and parental consent, this prospective, randomized, double blind study included 60 patients (age 3-15 yrs). Patients received IV midazolam 0.05 mgkg-1 as premedication. Anaesthesia was induced with fentanyl 2 μgkg-1 and propofol 3 mgkg-1. Patient's respiration was then assisted with 1% halothane in 100% oxygen over 1 minute (denitrogenation). Patients were randomized to receive either 1 mgkg-1 or 0.5 mgkg-1 succinylcholine. Tracheal intubation conditions were graded 60s after succinylcholine administration. Patients were left apnoeic after succinylcholine injection till resumption of spontaneous breathing. Duration between succinylcholine injection to resumption of spontaneous breathing resumption was noted as duration of apnoea. Data were analyzed with chi-square test and student t test. P<0.05 was considered significant. Results : Intubating conditions were acceptable in 29/30 children in succinylcholine 1 mgkg-1 group as against 28/30 children in succinylcholine 0.5 mgkg-1 group (P=0.55). Duration of apnoea was significantly less in succinylcholine 0.5 mgkg-1 group [114 (46) seconds] compared to succinylcholine 1 mgkg-1 group [185 (45) seconds] (P=0.00). Conclusions : Succinylcholine 0.5 mgkg-1 provides clinically acceptable intubating conditions comparable to that of succinylcholine 1 mgkg-1. Duration of apnoea with 0.5 mgkg-1 succinylcholine was significantly less when compared with 1 mgkg-1 succinylcholine.

Original languageEnglish
Pages (from-to)413-416
Number of pages4
JournalJournal of Anaesthesiology Clinical Pharmacology
Volume25
Issue number4
Publication statusPublished - 10-2009

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Succinylcholine
Apnea
Intubation
Respiration
Parental Consent
Oxyhemoglobins
Injections
Premedication
Research Ethics Committees
Midazolam
Fentanyl
Propofol
Halothane
Chi-Square Distribution
Double-Blind Method
Ventilation

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine
  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

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title = "Comparative evaluation of low dose succinylcholine against standard intubating dose in children",
abstract = "Background : Critical oxyhaemoglobin desaturation can occur if ventilation is unassisted with the conventional intubation dose of 1.0mgkg-1 succinylcholine. We conducted this study to evaluate the role of low dose succinylcholine in producing acceptable intubating conditions during rapid tracheal intubation in paediatric patients and whether it leads to a lesser duration of apnoea. Patients & Methods: After IRB approval and parental consent, this prospective, randomized, double blind study included 60 patients (age 3-15 yrs). Patients received IV midazolam 0.05 mgkg-1 as premedication. Anaesthesia was induced with fentanyl 2 μgkg-1 and propofol 3 mgkg-1. Patient's respiration was then assisted with 1{\%} halothane in 100{\%} oxygen over 1 minute (denitrogenation). Patients were randomized to receive either 1 mgkg-1 or 0.5 mgkg-1 succinylcholine. Tracheal intubation conditions were graded 60s after succinylcholine administration. Patients were left apnoeic after succinylcholine injection till resumption of spontaneous breathing. Duration between succinylcholine injection to resumption of spontaneous breathing resumption was noted as duration of apnoea. Data were analyzed with chi-square test and student t test. P<0.05 was considered significant. Results : Intubating conditions were acceptable in 29/30 children in succinylcholine 1 mgkg-1 group as against 28/30 children in succinylcholine 0.5 mgkg-1 group (P=0.55). Duration of apnoea was significantly less in succinylcholine 0.5 mgkg-1 group [114 (46) seconds] compared to succinylcholine 1 mgkg-1 group [185 (45) seconds] (P=0.00). Conclusions : Succinylcholine 0.5 mgkg-1 provides clinically acceptable intubating conditions comparable to that of succinylcholine 1 mgkg-1. Duration of apnoea with 0.5 mgkg-1 succinylcholine was significantly less when compared with 1 mgkg-1 succinylcholine.",
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Comparative evaluation of low dose succinylcholine against standard intubating dose in children. / Ellango, A. P.; Krishna, H. M.; Kini, Gurudas.

In: Journal of Anaesthesiology Clinical Pharmacology, Vol. 25, No. 4, 10.2009, p. 413-416.

Research output: Contribution to journalArticle

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AU - Kini, Gurudas

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N2 - Background : Critical oxyhaemoglobin desaturation can occur if ventilation is unassisted with the conventional intubation dose of 1.0mgkg-1 succinylcholine. We conducted this study to evaluate the role of low dose succinylcholine in producing acceptable intubating conditions during rapid tracheal intubation in paediatric patients and whether it leads to a lesser duration of apnoea. Patients & Methods: After IRB approval and parental consent, this prospective, randomized, double blind study included 60 patients (age 3-15 yrs). Patients received IV midazolam 0.05 mgkg-1 as premedication. Anaesthesia was induced with fentanyl 2 μgkg-1 and propofol 3 mgkg-1. Patient's respiration was then assisted with 1% halothane in 100% oxygen over 1 minute (denitrogenation). Patients were randomized to receive either 1 mgkg-1 or 0.5 mgkg-1 succinylcholine. Tracheal intubation conditions were graded 60s after succinylcholine administration. Patients were left apnoeic after succinylcholine injection till resumption of spontaneous breathing. Duration between succinylcholine injection to resumption of spontaneous breathing resumption was noted as duration of apnoea. Data were analyzed with chi-square test and student t test. P<0.05 was considered significant. Results : Intubating conditions were acceptable in 29/30 children in succinylcholine 1 mgkg-1 group as against 28/30 children in succinylcholine 0.5 mgkg-1 group (P=0.55). Duration of apnoea was significantly less in succinylcholine 0.5 mgkg-1 group [114 (46) seconds] compared to succinylcholine 1 mgkg-1 group [185 (45) seconds] (P=0.00). Conclusions : Succinylcholine 0.5 mgkg-1 provides clinically acceptable intubating conditions comparable to that of succinylcholine 1 mgkg-1. Duration of apnoea with 0.5 mgkg-1 succinylcholine was significantly less when compared with 1 mgkg-1 succinylcholine.

AB - Background : Critical oxyhaemoglobin desaturation can occur if ventilation is unassisted with the conventional intubation dose of 1.0mgkg-1 succinylcholine. We conducted this study to evaluate the role of low dose succinylcholine in producing acceptable intubating conditions during rapid tracheal intubation in paediatric patients and whether it leads to a lesser duration of apnoea. Patients & Methods: After IRB approval and parental consent, this prospective, randomized, double blind study included 60 patients (age 3-15 yrs). Patients received IV midazolam 0.05 mgkg-1 as premedication. Anaesthesia was induced with fentanyl 2 μgkg-1 and propofol 3 mgkg-1. Patient's respiration was then assisted with 1% halothane in 100% oxygen over 1 minute (denitrogenation). Patients were randomized to receive either 1 mgkg-1 or 0.5 mgkg-1 succinylcholine. Tracheal intubation conditions were graded 60s after succinylcholine administration. Patients were left apnoeic after succinylcholine injection till resumption of spontaneous breathing. Duration between succinylcholine injection to resumption of spontaneous breathing resumption was noted as duration of apnoea. Data were analyzed with chi-square test and student t test. P<0.05 was considered significant. Results : Intubating conditions were acceptable in 29/30 children in succinylcholine 1 mgkg-1 group as against 28/30 children in succinylcholine 0.5 mgkg-1 group (P=0.55). Duration of apnoea was significantly less in succinylcholine 0.5 mgkg-1 group [114 (46) seconds] compared to succinylcholine 1 mgkg-1 group [185 (45) seconds] (P=0.00). Conclusions : Succinylcholine 0.5 mgkg-1 provides clinically acceptable intubating conditions comparable to that of succinylcholine 1 mgkg-1. Duration of apnoea with 0.5 mgkg-1 succinylcholine was significantly less when compared with 1 mgkg-1 succinylcholine.

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