Determination of optimal dose of succinylcholine to facilitate endotracheal intubation in pregnant females undergoing elective cesarean section

Abstract

Aims: The study was carried out to find the optimal dose of succinylcholine for pregnant females, undergoing elective cesarean section under general anesthesia, in order to achieve excellent intubation conditions for a successful endotracheal intubation. Materials and Methods: One hundred and twenty pregnant females aged between 20 and 35 years were randomly allocated into 4 groups of 30 patients each. Group I received Inj. succinylcholine 0.5 mg/kg, Group II received 0.6 mg/kg, Group III received 1.0 mg/kg, and Group IV received 1.5 mg/kg intravenously. The response to ulnar nerve stimulation at the wrist was recorded using the peripheral nerve stimulator. Grading of intubation conditions was done 60 s after Inj. succinylcholine administration. Peak effect, peak time, and duration of absent respiratory movement (apnea time) was noted. Statistical Analysis: One-way analysis of variance (ANOVA) with post hoc analysis (Bonferroni test) has been applied to see significance among groups for continuous variables and the Chi-square test was performed for categoric variables. SPSS v 16 was used for statistical analysis for the study. Results: Peak effect achieved was similar with 0.6, 1.0, and 1.5 mg/kg. There was no statistically significant difference (P >0.05) in the time taken to achieve the peak effect (peak time) between 1.0 and 1.5 mg/kg. Apnea time was 242.7 ΁ 7.1 s with 1.0 mg/kg and 377.7 ΁ 28.9 s with 1.5 mg/kg (P < 0.001). Intubating conditions were poor with 0.5 mg/kg, good with 0.6 mg/kg, and excellent with 1.0 and 1.5 mg/kg. Conclusion: The dose of 1.0 mg/kg of succinylcholine produces excellent intubation conditions in pregnant females similar to the conventional dose of 1.5 mg/kg and is associated with a significantly shorter duration of action.

Keywords

• Caesarean section
• intubation conditions
• pregnancy
• succinylcholine