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Continuous succinylcholine infusion and phase II block in short surgical procedures
1Department of Anesthesiology, National Taiwan University Hospital, Taipei, R.O.C.
Ma Zui Xue Za Zhi = Anaesthesiologica Sinica
|December 1, 1993
Summary
Continuous succinylcholine infusion for short surgeries showed varied neuromuscular block responses. Recovery times did not significantly differ between phase II block types but were shorter than single-dose succinylcholine.
Area of Science:
- Anesthesiology
- Pharmacology
- Neurosurgery
Background:
- Neuromuscular blockade is crucial in anesthesia.
- Succinylcholine is commonly used, but its characteristics with continuous infusion need further study.
- Phase II block can occur with succinylcholine, impacting recovery.
Purpose of the Study:
- To evaluate continuous succinylcholine infusion for short surgical procedures (<90 min).
- To compare neuromuscular blockade characteristics and recovery times with single-dose succinylcholine.
- To investigate the incidence and impact of phase II block during continuous infusion.
Main Methods:
- 15 adult patients received continuous succinylcholine infusion during nitrous-oxide-isoflurane anesthesia.
- Ulnar nerve stimulation with train-of-four (TOF) was used to monitor neuromuscular blockade.
- Infusion rates were adjusted to maintain 90-95% twitch depression; comparison with a single-dose group (n=13).
Main Results:
- The mean infusion duration was 50.74 minutes; steady-state infusion rate was 83.5 µg/kg/min.
- Five patients developed phase II block (IB), while ten did not (IA).
- Recovery times were not significantly different between IA and IB groups but were significantly shorter than the single-dose group.
Conclusions:
- Continuous succinylcholine infusion is effective for short procedures, maintaining neuromuscular blockade.
- Phase II block incidence was 33% in this study.
- Continuous infusion offers faster recovery compared to single-dose succinylcholine, irrespective of phase II block presence.
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