Lidocaine Modifies the Effect of Succinylcholine on Muscle Oxygen Consumption in Dogs

Effect of suxamethonium vs rocuronium on onset of oxygen desaturation during apnoea following rapid sequence induction

“…Moreover, lidocaine was found to decrease fasciculations caused by suxamethonium during induction of anaesthesia [13‐14]. Lidocaine has also been shown to attenuate the increase in total body oxygen consumption associated with suxamethonium in normal skeletal muscle [15]. The pre‐junctional release of acetylcholine associated with suxamethonium administration [16] is reduced by lidocaine leading to decreased fasciculations, and subsequently a reduction in total body oxygen consumption [17].…”

Desaturation following rapid sequence induction using succinylcholine vs. rocuronium in overweight patients

“…The amount of oxygen consumption is related to the succinylcholine dose. Previous studies showed that 0.25 mg/kg succinylcholine doubles oxygen consumption in normal muscle, 24 and oxygen consumption increases as much as 150% with 2 mg/kg succinylcholine 12 . A previous study demonstrated that 1 min after the administration of succinylcholine, as opposed to rocuronium, the saturation of blood oxygen was similar but the levels of blood lactic acid were significantly higher in the right atrium 25 .…”

“…Succinylcholine is the most commonly used depolarizing neuromuscular blocking drug in rapid sequence induction of general anesthesia because of its fast onset and short duration. Unfortunately, it increases muscle oxygen consumption as a result of skeletal muscle fasciculation 12 and it can cause serious side effects such as malignant hyperthermia. Rocuronium, a non‐depolarizing muscle relaxant, has an onset of action that is more rapid than other available non‐depolarizing neuromuscular blocking agents.…”

Effect of patient weight on first pass success and neuromuscular blocking agent dosing for rapid sequence intubation in the emergency department

“…Due to a decrease in functional residual capacity in obese patients, they have a decreased oxygen reserve, which could put them at risk for first pass failure 31. Furthermore, the fasciculations produced by succinylcholine can potentially increase oxygen consumption and thus reduce the safe apnoea time during intubation 32. Studies have shown a faster onset of oxygen desaturation and a decreased safe apnoea time with succinylcholine versus rocuronium 33 34.…”