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.