Comparative study of 0.5mg/Kg and 1.0mg/Kg suxamethonium in achieving acceptable condition for endotracheal intubation

Abstract

Background: Airway management is of utmost importance to the anaesthetist because failure to secure an adequate airway can result to morbidity and mortality. Endotracheal intubation is the cornerstone in airway management. This study investigated the effectiveness of lower dose of 0.5mg/kg suxamethonium in achieving acceptable condition for successful endotracheal intubation.

Objective: To investigate the effectiveness of 0.5mg/kg suxamethonium in achieving the relaxation needed for successful endotracheal intubation.

Methodology: A prospective double-blind study was done on 500 patients of ASA class I or II, undergoing elective surgery requiring general anaesthesia and endotracheal intubation. Patients were randomized into two: Group ‘A’ received 0.5mg/kg suxamethonium; Group ‘B’ received 1.0mg/kg suxamethonium intravenously. Anaesthesia was induced with propofol. Intubation conditions were assessed clinically one minute after suxamethonium administration by Viby-Mogensen scoring system.

Result: Clinically acceptable intubation conditions were obtained in 91.6% and 96.4% of the patients after administration of 0.5mg/kg and 1.0mg/kg suxamethonium in groups A and B, respectively. The Mallampati classes of pharyngeal structures, Cormack grade, and laryngoscopy and intubation duration were of similar outcomes in the two groups. Intubation was successful in all (100%) patients. Twenty-one (8.4%) and nine (3.6%) patients in 0.5mg/kg and 1.0mg/kg group respectively required additional 0.5mg/kg of suxamethonium administration.

Conclusion: Acceptable conditions for endotracheal intubation were achieved with lower dose (0.5mg/kg) suxamethonium.

Keywords: Elective surgery, Muscle relaxant, Airway management, Balanced anaesthesia