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Anesthesia Progress logoLink to Anesthesia Progress
. 1990 Sep-Oct;37(5):238–243.

Comparative trial of succinylcholine vs low dose atracurium-lidocaine combination for intubation in short outpatient procedures.

N H Luyk 1, J M Weaver 1, C Quinn 1, S Wilson 1, F M Beck 1
PMCID: PMC2148610  PMID: 2096747

Abstract

Despite its many disadvantages, succinylcholine is the most commonly used drug for intubation of patients for short out-patient procedure. This double blind trial compared a low dose atracurium/lidocaine combination to succinylcholine for intubation in 40 ASA1 adult patients. Low dose atracurium/lidocaine provided clinical intubating conditions at two minutes and cardiovascular stability equivalent to succinylcholine with significantly less myalgia. Spontaneous respiration was slower after low dose atracurium/lidocaine relative to succinylcholine. Low dose atracurium/lidocaine may provide an acceptable alternative to succinylcholine for intubation in short outpatient procedures.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abou-Madi M. N., Keszler H., Yacoub J. M. Cardiovascular reactions to laryngoscopy and tracheal intubation following small and large intravenous doses of lidocaine. Can Anaesth Soc J. 1977 Jan;24(1):12–19. doi: 10.1007/BF03006808. [DOI] [PubMed] [Google Scholar]
  2. Astley B. A., Hackett H., Hughes R., Payne J. P. Recovery of respiration following neuromuscular blockade with atracurium and alcuronium. Br J Anaesth. 1986;58 (Suppl 1):75S–79S. doi: 10.1093/bja/58.suppl_1.75s. [DOI] [PubMed] [Google Scholar]
  3. Bennetts F. E., Khalil K. I. Reduction of post-suxamethonium pain by pretreatment with four non-depolarizing agents. Br J Anaesth. 1981 May;53(5):531–536. doi: 10.1093/bja/53.5.531. [DOI] [PubMed] [Google Scholar]
  4. Brodsky J. B., Brock-Utne J. G., Samuels S. I. Pancuronium pretreatment and post-succinylcholine myalgias. Anesthesiology. 1979 Sep;51(3):259–261. doi: 10.1097/00000542-197909000-00017. [DOI] [PubMed] [Google Scholar]
  5. Chatterji S., Thind S. S., Daga S. R. Lignocaine pretreatment for suxamethonium. A clinicobiochemical study. Anaesthesia. 1983 Sep;38(9):867–870. doi: 10.1111/j.1365-2044.1983.tb12252.x. [DOI] [PubMed] [Google Scholar]
  6. Dodgson M. S., Heier T., Steen P. A. Atracurium compared with suxamethonium for outpatient laparoscopy. Br J Anaesth. 1986;58 (Suppl 1):40S–43S. doi: 10.1093/bja/58.suppl_1.40s. [DOI] [PubMed] [Google Scholar]
  7. Gergis S. D., Sokoll M. D., Mehta M., Kemmotsu O., Rudd G. D. Intubation conditions after atracurium and suxamethonium. Br J Anaesth. 1983;55 (Suppl 1):83S–86S. [PubMed] [Google Scholar]
  8. Hamill J. F., Bedford R. F., Weaver D. C., Colohan A. R. Lidocaine before endotracheal intubation: intravenous or laryngotracheal? Anesthesiology. 1981 Nov;55(5):578–581. doi: 10.1097/00000542-198111000-00016. [DOI] [PubMed] [Google Scholar]
  9. Hilgenberg J. C., Stoelting R. K., Harris W. A. Systemic vascular responses to atracurium during enflurane-nitrous-oxide anesthesia in humans. Anesthesiology. 1983 Mar;58(3):242–244. doi: 10.1097/00000542-198303000-00007. [DOI] [PubMed] [Google Scholar]
  10. Himes R. S., Jr, DiFazio C. A., Burney R. G. Effects of lidocaine on the anesthetic requirements for nitrous oxide and halothane. Anesthesiology. 1977 Nov;47(5):437–440. doi: 10.1097/00000542-197711000-00010. [DOI] [PubMed] [Google Scholar]
  11. Hughes R., Payne J. P. Clinical assessment of atracurium using the single twitch and tetanic responses of the adductor pollicis muscles. Br J Anaesth. 1983;55 (Suppl 1):47S–52S. [PubMed] [Google Scholar]
  12. Melnick B., Chalasani J., Uy N. T., Phitayakorn P., Mallett S. V., Rudy T. E. Decreasing post-succinylcholine myalgia in outpatients. Can J Anaesth. 1987 May;34(3 ):238–241. doi: 10.1007/BF03015159. [DOI] [PubMed] [Google Scholar]
  13. Miller R. D. The priming principle. Anesthesiology. 1985 Apr;62(4):381–382. doi: 10.1097/00000542-198504000-00001. [DOI] [PubMed] [Google Scholar]
  14. Payne J. P., Hughes R. Evaluation of atracurium in anaesthetized man. Br J Anaesth. 1981 Jan;53(1):45–54. doi: 10.1093/bja/53.1.45. [DOI] [PubMed] [Google Scholar]
  15. Poulton T. J., James F. M., 3rd Cough suppression by lidocaine. Anesthesiology. 1979 May;50(5):470–472. doi: 10.1097/00000542-197905000-00018. [DOI] [PubMed] [Google Scholar]
  16. Ramsey F. M., White P. A., Stullken E. H., Lineberry C. G., Allen L. L. Clinical use of atracurium during N2O/O2, fentanyl, and N2O/O2, enflurane anesthesia regimens. Anesthesiology. 1984 Sep;61(3):328–331. doi: 10.1097/00000542-198409000-00013. [DOI] [PubMed] [Google Scholar]
  17. Siler J. N., Mager J. G., Jr, Wyche M. Q., Jr Atracurium: hypotension, tachycardia and bronchospasm. Anesthesiology. 1985 May;62(5):645–646. [PubMed] [Google Scholar]
  18. Sokoll M. D., Gergis S. D., Mehta M., Kemmotsu O., Rudd D. Haemodynamic effects of atracurium in surgical patients under nitrous oxide, oxygen and isoflurane anaesthesia. Br J Anaesth. 1983;55 (Suppl 1):77S–79S. [PubMed] [Google Scholar]
  19. Stenlake J. B., Waigh R. D., Urwin J., Dewar G. H., Coker G. G. Atracurium: conception and inception. Br J Anaesth. 1983;55 (Suppl 1):3S–10S. [PubMed] [Google Scholar]
  20. Stirt J. A., Katz R. L., Murray A. L., Schehl D. L., Lee C. Modification of atracurium blockade by halothane and by suxamethonium. A review of clinical experience. Br J Anaesth. 1983;55 (Suppl 1):71S–75S. [PubMed] [Google Scholar]
  21. Stirt J. A., Katz R. L., Schehl D. L., Lee C. Atracurium for intubation in man. A clinical and electromyographic study. Anaesthesia. 1984 Dec;39(12):1214–1221. doi: 10.1111/j.1365-2044.1984.tb06434.x. [DOI] [PubMed] [Google Scholar]
  22. Stoelting R. K., Peterson C. Heart-rate slowing and junctional rhythm following intravenous succinylcholine with and without intramuscular atropine preanesthetic medication. Anesth Analg. 1975 Nov-Dec;54(6):705–709. doi: 10.1213/00000539-197511000-00007. [DOI] [PubMed] [Google Scholar]
  23. Viby-Mogensen J. Correlation of succinylcholine duration of action with plasma cholinesterase activity in subjects with the genotypically normal enzyme. Anesthesiology. 1980 Dec;53(6):517–520. doi: 10.1097/00000542-198012000-00017. [DOI] [PubMed] [Google Scholar]
  24. Waters D. J., Mapleson W. W. Suxamethonium pains: hypothesis and observation. Anaesthesia. 1971 Apr;26(2):127–141. doi: 10.1111/j.1365-2044.1971.tb04753.x. [DOI] [PubMed] [Google Scholar]

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