Intubating conditions following rapid sequence induction with three doses of succinylcholine

Prakash, Smita; Barde, Sushma; Thakur, Preeti; Gogia, Anoop Raj; Singh, Rajvir

doi:10.4103/0019-5049.96309

Cited by 4 publications

(10 citation statements)

References 17 publications

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“…One trial was not blinded and therefore judged to be at high risk of bias ( Figure S1 and S2) [23]. Two trials reported sources of authors' funding and conflicts of interest [24,26].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In three studies, patients were premedicated (Table 1) [21,23,25]. Three studies used a true RSI [21,23,24], and two a modified RSI [22,25]. All five used intravenous propofol 2 mg kg − 1 with a concomitant intravenous opioid for induction.…”

Section: Induction Techniquesmentioning

confidence: 99%

“…The sixth study used an induction technique with sevoflurane without intravenous opioids; there was no delay between loss of consciousness and the administration of succinylcholine [26]. One study specified the use of a cricoid pressure [24]. In all studies, intubating conditions were evaluated 50 to 60 s after the administration of succinylcholine.…”

Section: Induction Techniquesmentioning

confidence: 99%

“…In all studies, intubating conditions were evaluated 50 to 60 s after the administration of succinylcholine. Four studies specified that intubations were performed by an experienced anaesthetist [21][22][23][24].…”

Section: Induction Techniquesmentioning

confidence: 99%

“…With the standard succinylcholine regimen (1.0 mg kg − 1 ), the incidence of excellent intubating conditions ranged from 58% [26] to 100% [24,25] (cumulative number of patients, 185 of 233 [79%]) (Fig. 2).…”

Section: Quality Of Intubating Conditions Excellent Intubating Conditmentioning

confidence: 99%

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The optimal dose of succinylcholine for rapid sequence induction: a systematic review and meta-analysis of randomized trials

et al. 2020

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Background: The evidence base for the widely accepted standard regimen of succinylcholine for rapid sequence induction (1.0 mg kg − 1) remains unclear. Methods: We performed a systematic review and meta-analysis of randomized trials comparing any succinylcholine regimen with the standard regimen (1.0 mg kg − 1) and reporting on intubating conditions and/or apnoea times. Results were expressed as absolute risk differences (ARD) for dichotomous data and mean differences (MD) for continuous data. Results: We retrieved six trials with relevant data of 864 patients (ASA 1 or 2, aged 18-65 years, body mass index < 30 kg m − 2). Four regimens (0.3, 0.4, 0.5, 0.6 mg kg − 1) were compared with 1.0 mg kg − 1 in at least three trials each, and three (0.8, 1.5, 2 mg kg − 1) in one each. With 0.3 to 0.5 mg kg − 1 , the likelihood of excellent intubating conditions was significantly decreased (ARD − 22% to − 67%). With 0.3 and 0.4 mg kg − 1 , but not with 0.5, 0.6, 0.8, 1.5 and 2.0 mg kg − 1 , the likelihood of unacceptable intubating conditions was significantly increased (ARD + 22% and + 32%, respectively). With 2.0 mg kg − 1 , but not with 0.8 or 1.5 mg kg − 1 , the likelihood of excellent intubating conditions was significantly increased (ARD + 23%). Apnoea times were significantly shorter with regimens ≤0.8 mg kg − 1 (MD − 1.0 to − 3.4 min) but were not reported with 1.5 or 2.0 mg kg − 1. Conclusions: With succinylcholine regimens ≤0.5 mg kg − 1 , excellent intubating conditions are less likely and apnoea times are shorter, compared with 1 mg kg − 1. With 0.3 and 0.4 mg kg − 1 , unacceptable intubating conditions are more common. Succinylcholine 1.5 mg kg − 1 does not produce more often excellent conditions compared with 1 mg kg − 1 , while 2.0 mg kg − 1 does, but the database with these regimens is weak and apnoea times remain unknown. Limited information size and strong statistical heterogeneity decrease the certainty of the evidence.

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“…One trial was not blinded and therefore judged to be at high risk of bias ( Figure S1 and S2) [23]. Two trials reported sources of authors' funding and conflicts of interest [24,26].…”

Section: Study Characteristicsmentioning

confidence: 99%