The potency of succinylcholine in obese adolescents.

Autor:	Rose JB; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, and Department of Anesthesiology and Pediatrics, University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania, USA., Theroux MC, Katz MS
Jazyk:	angličtina
Zdroj:	Anesthesia and analgesia [Anesth Analg] 2000 Mar; Vol. 90 (3), pp. 576-8.
DOI:	10.1097/00000539-200003000-00015
Abstrakt:	Unlabelled: We constructed a single-dose response curve for succinylcholine in 30 obese adolescents during thiopental-fentanyl anesthesia administration by using 100 microg/kg, 150 microg/kg, or 250 microg/kg IV. The maximal response (percent depression of neuromuscular function) of the adductor pollicis to supramaximal train-of-four stimuli was recorded by using a Datex (Helsinki, Finland) relaxograph. Linear regression and inverse prediction were used to determine doses of succinylcholine to produce 50% (ED(50)), 90% (ED(90)), and 95% (ED(95)) depression of neuromuscular function. The ED(50), ED(90), and ED(95) were 152.8 microg/kg (95% confidence interval: 77.8-299.5), 275.4 microg/kg (95% confidence interval: 142-545.7), and 344.3 microg/kg (95% confidence interval: 175.3-675. 3), respectively. This ED(50) is similar to the dose reported for similarly aged, nonobese adolescents, 147 microg/kg. The previously reported ED(95) for succinylcholine in nonobese adolescents, 270 microg/kg, is within the 95% confidence interval generated for ED(95) in our study. Implications: The potency estimates for succinylcholine in obese (body mass index > 30 kg/m(2)) adolescents are comparable to those in similarly aged nonobese adolescents when dosing is calculated based on total body mass and not lean body mass. When a rapid sequence induction of anesthesia is considered in an obese adolescent, the dose of succinylcholine should be based on actual (not lean) body mass.
Databáze:	MEDLINE
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