Effects of Etomidate Injection on Succinylcholine-Induced Fasciculation.

PURPOSE: To assess the effect of etomidate injection on succinylcholine-induced fasciculations through a randomized controlled trial.

METHODS

Intravenous succinylcholine (2 mg/kg) was administered to 100 adult patients undergoing elective vocal cord surgery, with allocation to two groups: immediate group, where succinylcholine was administered immediately, and delayed group, where succinylcholine was administered 15 sec after injection of etomidate 0.2 mg/kg. The two groups were compared in terms of the severity and duration of muscle fasciculation caused by succinylcholine and the incidence of postoperative myalgia.

FINDINGS: The severity of fasciculations graded on a 4-point scale was considered the primary outcome. Compared with the delayed group, the immediate group exhibited substantially reduced fasciculation severity scores (P = 0.005). A lower incidence of postoperative myalgia was observed in the immediate group than in the delayed group (P = 0.031). Furthermore, in the delayed group, the heart rate after intervention decreased more significantly (P = 0.014). No differences in other adverse effects were observed.

IMPLICATIONS: The severity of succinylcholine-induced fasciculations and the incidence of postoperative myalgia were significantly reduced without adversely affecting intubation conditions or hemodynamics by injecting a 0.2 mg/kg dose of etomidate immediately before administering 2 mg/kg succinylcholine.