No abstract available.
Humans ; Paralysis* ; Pseudocholinesterase* ; Succinylcholine*

Succinylcholine(SCh)-induced muscle fasciculations may be prevented by pretreatment with small doses of nondepolarizing muscle relaxants. The optimal timing of pretreatment to abolish fasciculation varies according to the drug used and dose. In this study, we determined the optimal timing of pretreatment of pancuronium to prevent muscular fasciculation in 100 patients. Each group (n=20) was received pancuronium 0.015 mg/kg at 1, 2, 3, 4, 5 minutes before SCh 3 mg/kg administration, respectively. The degree of fasciculations after SCh administration was observed and classified into one of 4 grade. There were significant differences between each groups (Ridit scores=10.078, p<0.01) To compare observed fasciculations of one grpup with those of the others, the degree of fasciculations was summed according to an arbitrary scale. The summation of grade in 4 minute group was lowest in this scale. It was concluded that the optimal timing of pretreatment, pancuronium 0.015 mg/kg, was 4 minutes before SCh 3 mg/kg injection.
Fasciculation* ; Humans ; Pancuronium* ; Succinylcholine*

BACKGROUND: Mivacurium has a characteristics of rapid onset and the shortest duration of non- depolarizing neuromuscular relaxants and the onset of action could be accelerate more rapidly by using priming principle. The purpose of this study was to compare the onset time of mivacurium by priming principle with succinylcholine during rapid endotracheal intubation. METHODS: 36 patients were randomly divided into 3 groups: mivacurium group by priming principle (Group 1), mivacurium group by bolus injection (Group 2) and succinylcholine group (Group 3). In Group 1, subparalyzing dose of 0.02 mg/kg was administered 2 minutes before principle dose of 0.25 mg/kg was given. Onset time and intubating conditions were observed when twitch tension was reduced by 25% block in each group. RESULTS: The onset of Group 1 (75 sec) was significantly faster than that of Group 2 (90 sec) (p<0.05) but was significantly slower than that of Group 3 (37.5 sec) (p<0.05). Intubating conditions were excellent in all groups. CONCLUSIONS: The attempts of priming principle with mivacurium could accelerate the onset of action of mivacurium compared with that of bolus injection but their onsets were shorter than those produced by succinylcholine.
Humans ; Intubation, Intratracheal* ; Succinylcholine*

Background: Succinylcholine is drug muscle relaxant the only depolarizing current can also be used in clinical. Objectives: The current study assessed the intubation condition and side effects of different doses of succinylcholine. Subjects and method: In a randomized, double blind trial, 90 patients were divided into 3 groups. 1, 1.5 or 2 mg/kg succinylcholine was added with Fentanyl and Thiopental for induction in group I, II and III, respectively. A rapid induction and postoperative myalgia were evaluated. Results: Fasciculation time as well as myalgia increased significantly by the doses. Intubation conditions were better in group II and III. Increase of kalemia was seen in all groups, but most significantly in group III (3,7 \xb1 0,3 vs 3,3 \xb1 0,2, p<0,05). Conclusion: 1, 1.5 or 2 mg/kg succinylcholine equally provided acceptable intubation condition. Succinylcholine 2 mg/kg induced more fasciculation, myalgia and increase of kalemia.
Succinylcholine/ adverse effects ; Intubation ;

No abstract available.
Larynx* ; Pharmacology ; Succinylcholine* ; Vecuronium Bromide*

BACKGROUND: Succinylcholine is still the most frequently used muscle relaxant for rapid-sequence intubation despite its well-known side effects. Rocuronium has been reported to develop a rapid onset of action and may be suitable as a component of a rapid-sequence intubation. The purpose of this study was to compare tracheal intubating conditions by following different rocuronium doses and application techniques versus succinylcholine. METHODS: Fifty nine ASA physical status 1 and 2 adult patients scheduled for elective surgeries were anesthetized with thiopental sodium 5 mg/kg and muscle relaxant using a rapid-sequence technique. Group I (n = 12) received succinylcholine 1.0 mg/kg, group II (n = 15) received rocuronium 1.0 mg/kg, group III (n = 16) received rocuronium 0.6 mg/kg as a single bolus dose, and group IV (n = 16) received a priming dose of rocuronium 0.06 mg/kg followed three minutes later by rocuronium 0.54 mg/kg. Intubation was performed 60 seconds after the administration of muscle relaxant and intubating conditions were evaluated by clinical scoring (Table 1), and train-of-four (TOF) count of the adductor pollicis by accelerography. RESULTS: TOF counts of group I were lower than those of groups III and IV, and those of group II were lower than group III (P < 0.0083). Group II had intubating conditions similar to group I. The intubating conditions of groups I and II were better than those of groups III and IV (P < 0.0083). CONCLUSIONS: Rocuronium 1.0 mg/kg may be a suitable alternative for succinylcholine 1.0 mg/kg during rapid-sequence intubation. Priming principle does not produce faster or better intubating conditions than a single bolus injection.
Adult ; Humans ; Intubation* ; Succinylcholine ; Thiopental

BACKGROUND: The purpose of this study was to determine whether esmolol augmented the increase in serum K+ following administration of succinylcholine. METHODS: Forty patients were randomly divided esmolol group (n=20) and control group (n=20). The esmolol group received a 1 minute rapid infusion of 500 mcg/kg/min followed by a continuous infusion of 200 mcg/kg/min for 4 minutes before administration of succinylcholine. Serum potassium level, mean arterial blood pressure and pulse rate were measured prior to induction(baseline) and 1, 3, 5, 10, 15, 30, 45, 60, 75, 90 minutes after administration of succinylcholine. RESULTS: Serum potassium level was significantly higher in esmolol group after 3 and 15 minutes after succinylcholine than control group. Mean arterial blood pressure was not significantly different between two groups except 10 minute but the pulse rate significantly lower 1, 3, 5, 10 and 15 minutes in esmolol group than control group. CONCLUSIONS: Esmolol does not significantly elevate serum potassium level in clinical use(1 minute infusion of 500 mcg/kg/min followed by infusion of 200 mcg/kg/min for 4 minutes) after administration of succinylcholine. So succinylcholine can be used safely in the presence of beta-1-selective adrenergic blockade. And esmolol can attenuate more effectively increase of pulse rate than mean arterial pressure.
Arterial Pressure ; Heart Rate ; Humans ; Potassium* ; Succinylcholine*

Succinylcholine, 1.5mg/kg, was injected preoperatively and postoperatively under the general anesthesia in 21 strabismus patients. We measured ocular position induced by succinylcholine under the general anesthesia and compared it with ocular position of conscious state from photograph. Regression analysis was performed to find the predictive relationships between preanesthetic and preoperative succinylcholine-induced ocular position and postoperative succinylcholine-induced ocular position and ocular position at postoperative 1 week. The results were as follows: 1) X: Preoperative succinylcholine induced ILD(interlimbal distance) under the anesthesia. Y: Preanesthetic ILD. Y=0.71X+10.6, R=0.82(p<0.025). 2) X: Postoperative succinylcholine induced ILD. Y: Postoperative 1 week ILD. Y=0.76X+9.14. R=0.74(p<0.005). The succinylcholine induced-ocular positions were highly correlated with those of conscious state.
Anesthesia ; Anesthesia, General* ; Humans ; Strabismus ; Succinylcholine*

Succinylcholine(SCC) is well known to elevate the serum potassium level and to threaten life in some cases. In order to minimize the elevation of serum potassium following SCC, several attempts have been made such as SCC tamming and pretreatment with pancuronium or lidocaine or diazepam. Our study was undertaken to evaluate the change of serum potassium following induction in 60 patients divided into 7 different groups; group l. SCC 1mg/kg; group ll. SCC 2 mg/kg, grouplll, SCC 1mg/kg after SCC 10mg; group IV, SCC 1mg/kg after pancuronium 0.015mg/kg, group V. Pnacuronium 0.1mg/kg; group VI, SCC 1mg/kg after Lidocaine 1mg/kg; grou VII, SCC 1mg/kg after Diazepam 0.2mg/kg. The results were as follows: 1) Serum potassium were increased 0.14mEq/L in group l and 0.17 mEq/L in group ll. 2) Serum potassium were decreased in group lll, VI and VII than their control values but they were not statistically significant. 3) The decrease in serum potassium was most significant in group IV and V.
Calcium ; Diazepam ; Humans ; Lidocaine ; Pancuronium ; Potassium ; Succinylcholine

BACKGROUND: Subparalyzing doses of nondepolarizing muscle relaxants are often given prior to succinylcholine to reduce the adverse effects of succinylcholine. We designed this study to determine the optimal choice of nondepolarizing muscle relaxants and the optimal interval between pretreatment and succinylcholine administration. METHODS: 240 ASA I or II adult patients were randomized into six groups: groups V1.5 and V3 received 0.015 mg/kg of vecuronium 1.5 min and 3 min before succinylcholine; group R1, R1.5, and R3 received 0.09 mg/kg of rocuronium 1 min, 1.5 min and 3 min before succinylcholine; and group SCC received no pretreatment. In this study, 2 mg/kg of succinylcholine was used. The presence and severity of fasciculations and intubating conditions were evaluated. Myalgia was also recorded on postoperative days 1 and 2. RESULTS: Group R3 was significantly better than other groups in terms of preventing fasciculations, and was followed by groups R1.5, R1, V3, V1.5 and group SCC. Intubating conditions were significantly worse in all pretreated groups than in group SCC, but no significant differences were observed between the pretreated groups. CONCLUSIONS: Succinylcholine-induced fasciculations are effectively prevented by pretreating with rocuronium 3 min or 1.5 min prior to succinylcholine administration. However intubating conditions are worsened by pretreatments.
Adult ; Fasciculation ; Humans ; Myalgia ; Succinylcholine* ; Vecuronium Bromide*