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.
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: 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

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

The effect of prior administration of d-tubocurarine on the increased intraocular pressure associated with the use of succinylcholine was studied in 30 randomely selected human subjects, who did not have cardiopulmonary or ocular disease preoperatively. Intraocular pressures were measured with Schiotz tonometer. The major findings of this study were as follows: 1) When succinylcholine was given alone, a rise from 15.5mmHg to 18.OmmHg (16.1%) was seen(p<0.05). 2) When d-tubocurarine, 3mg, was given three minutes prior to the administration of succylchin oline, 15 healthy human subjects had no significant increase in intraocular pressure(p>0.05). 3) Intrsocular pressure were significantly increased in both groups after endotracheal intubation, but the d-tubocurarine precurarization group had minimal pressure compured to the succinylcholine alonegroup(p<0.05). An intraocular pressure increase was inhibited in the d-tubocurarine precurarization group. This simple, convenient method prevents the increased intraocular pressure associated with the use of succinylcholine.
Humans ; Intraocular Pressure* ; Intubation, Intratracheal ; Succinylcholine ; Tubocurarine*

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*

Small dose of nondepolarizing muscle relaxants are often recommended as prior medication of succinylcholine in order to avoid the elevation of intraocular pressure elicited by succinylcholine The effects of muscle relaxants on the intraocular pressure were studied in 45 human subjects. Intraocular pressure was significantly lowerd by d-tubocurarine 3 mg from 14.7 mmHg to 11.3 mmHg, and by pancuronium 0.08 mg/kg from 15.6 mmHg to 13.4 mmHg. When succinylcholine was given alone, subjects shows a mean elevation in intraocular pressure. There were no significant changes in intraocular pressure between d-tubocurarine and pancuronium given prior to succinylcholine.
Humans ; Intraocular Pressure* ; Pancuronium* ; Succinylcholine* ; Tubocurarine*

Succinylcholine induces a small increase in serum K+ (0.3~0.5mEq/l) in normal patients, but it may produce fatal increases in sensitive conditions, including severe burn, massive trauma, tetanus and neuromuscular disorders. Recently, interest has been focussed on the role of the adrenergic system in extrarenal potassium hemeostasis. According to this concept, beta-adrenergic stimulation enhances and conversely a blockade imparis celluar uptake of potassium. Meanwhile propranolol, a beta-adrenergic blocker, is an incresingly, common drug among surgical patients. Therefore, the present experiment was carried out on 66 patients in order to determine whether propranolol augments or prolongs the increases in serum K+ following succinylcholine injection(2mg/kg, I.V.). Serum K+ and Na+ levels were measured just prior to induction and at 3,5,10,30,60,90 minutes following succinylcholine administration. The patients were divided into three groups: Group 1: 26 patients without propranolol treatment, Group 2: 20 patients pretreat with divided doses of propranolol (320 mg b.i.d. p.o.). and Group 3: 20 patients on chronic propranolol therapy. The results were as follows. 1) Baseline K+ valuses were significantly higher in propranolol treated patients(Groups 2 and 3) than in non-treated patients(Group 1). 2) The magnitude of maximum increases in serum K+ following succinylcholine was 0.19mEq/l, 0.16mEq/l and 0.21mEq/l in group 1,2 and 3, respectively. 3) The time to peak increases in K+ was 30min, 5min and 3 min following succinylcholine in group 1,2 and 3, respectively. 4) Serum Na+ decreased significantly following succinylcholine administration in all groups, but there was no significant difference among the groups at other times. These results indicate that propranolol neither augments nor prolongs increases in serum K+ following succinylcholin injection. Thus succinylcholine can be used safely in the presence of a beta-adrenergic blockade.
Burns ; Humans ; Potassium ; Propranolol* ; Succinylcholine* ; Tetanus