Muscle relaxation with sublingual succinylcholine
Relajación muscular con succinilcolina sublingual
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Abstract
Objective: to determine the usefulness of succinylcholine applied sublingually as a muscle relaxant. This information is relevant to extrapolate to clinical situations in which intravenous administration is difficult due to technical reasons.
Methods: a controlled clinical trial was designed, in which low risk adult patients (ASA I and II) were assigned to receive sublingual succinylcholine (SSL) (1 mg / k), intramuscular (SIM) (5 mg / k) or intravenous (SIV) (1 mg / k) during anesthetic induction. Muscle relaxation was measured using the TOF watch® muscle contraction stimulator. The latency, action and recovery times were determined for each patient. The Mann-Whitney test was used to compare the times, Fisher's exact test for frequencies and SAS software version 8.2 to perform the statistical analyzes.
Results: five patients were randomly chosen in each group. Despite the small number, it was decided to suspend the admission of new cases, since significant differences were found very early. The latency time was significantly shorter in patients in whom SIV was used compared to SIM and SSL. The time of action was longer in those who underwent SIV compared with those with SIM without the difference reaching statistical significance. Only one patient of those who received SSL achieved a latency time of less than ten minutes and an action time of more than two minutes, compared to 100% of patients who received SIM or SIV (p = 0.02).
Conclusion: SSL at a dose of 1 mg / k is not useful as a muscle relaxant. More studies exploring different doses are required to determine the clinical utility of succinylcholine applied in this way.
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