Comparison on Succinylcholine Onset Time Assessed by Train of Four Stimulation Versus Clinical Judgment During Rapid Sequence Induction of Anesthesia

Study Overview
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Brief Summary
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Succinylcholine is a myorelaxant agent often used during rapid sequence induction for patients who need to undergo general anesthesia but who are at risk of pulmonary aspiration of gastric content. Whereas other myorelaxant agents are monitored with train of four stimulation to assess onset and duration, few anesthesiologists use train of four stimulation for onset of succinylcholine, as the anesthesiologists evaluate the effect with the time from injection (usually one minute) and the muscle fasciculation due to the release of acetylcholine. The data available on onset duration of this drug are old and bases on only few studies, but the succinylcholine if sometime harmful (anaphylaxis , cardiac arrest, bronchospasm). The investigators want to assess the onset time of succinylcholine with an objective toll , the train of four stimulation, and evaluate if the clinical judgment of the anesthesiologist is reliable to predict an adequate moment for endotracheal intubation.

Official Title
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Comparison on Succinylcholine Onset Time Assessed by Train of Four Stimulation Versus Clinical Judgment During Rapid Sequence Induction

Conditions
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Suxamethonium Sensitivity, Aspiration of Gastric Contents Into Respiratory Tract, Part Unspecified

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Every patient undergoing general anesthesia with the use of suxamethonium for induction as assessed by the anesthesiologist Exclusion Criteria: Patient under 18 years old Pregnant woman Nasotracheal intubation Monitoring of train of four at the adductor pollis impossible (such as patient with no arm )

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Onset of action of suxamethonium as assessed by the measurement of the train of four stimulation at the adductor pollis | Time, in seconds, between injection of suxamethonium and appearance of a value of zero on the train of four stimulation measurement (going to for on for to zero on for). | 60 seconds after the injection of suxamethonium | 
| Time from suxamethonium injection to laryngoscopy | Time, in seconds, between the injection of suxamethonium and the laryngoscopy realized by the anesthesiologist. | 60 seconds after the injection of suxamethonium | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients whom train of four was not 0 when they benefited from the laryngoscopy |  | 60 seconds after the injection of suxamethonium | 
| Complications associated with use of suwamethnonium or early laryngoscopy |  | 60 seconds after the injection of suxamethonium | 
| Main characteristics of the patients and intubation conditions |  | 60 seconds after the injection of suxamethonium |