quicker desat with succinylcholine?

22 Oct

Anesthesia study by Taha et al:

60 patients, n = 20 per study group

the key figure:

fig1

 

sux desaturated quicker than roc, and sux without lido/fentanyl desaturated even quicker.

authors suggest this may be due to increased oxygen consumption from muscle fasciculations

 

study by Marsch et al:  (401 patients)

duration of the intubation sequence was shorter after succinycholine than after rocuronium (81 ± 38 sec versus 95 ± 48 sec)”

but looking at both drugs, most intubation sequence times were within 150 sec.  (which is less than the desat to 95% times from the previous study)

 

BOTTOM LINE:

muscle fasciculations from succinylcholine may consume oxygen faster than with rocuronium (non-depolarizing paralytic).  

for most, may not be clinically important since it takes longer than the typical intubation to desat even with sux

for poor-reserve/difficult intubations (which may be prolonged), might consider a non-depolarizing paralytic instead of sux

 

References: anesthesia study, marsch study; Figure from anesthesia study

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