Pre-TX w/NDMB prior to SCh?

[beedog13]

I am a first-year SRNA at U. of Cincinnati and I would like to know how common it is in your practice to pre-treat with a low dose of a NDMB in order to decrease post-op soreness R/T fasciculations and/or any of the other possible side effects of SCh?

Seems as though those who do and do not are diametrically opposed groups...would love for you to share your perscectives...:typing

Beedog

[stanman1968]

If I use sux it is because I NEED RSI, otherwise I will take the 3-5 min and use vec. The end answer no I really do not "prime" the patient. Not against it if I used sux routinley I would, hope it helps.

[skipaway]

I routinely treat with Rocuronium 2.5mg for small adults and 5.0mg for the rest. After my Versed, that's the next drug I use to give it time to work. Sometimes the 5mg dose makes them feel weak so that's why I've added the 2.5mg option for smaller people. You definately see a difference in facsiculations after pre-treatment.

[alterego33]

While I rarely use succinylcholine any more for routine intubations, when I did I liked to pre-treat for two reasons.

1. Prevent the eflux of potassium from the cells that occurs with facilulations.

2. Prevent muscular pain.

Both of these are important to me; I want my patients to have a good experience from anesthesia and those muscular pains the next day are not consistent with a good experience and all of that potassium is not physiologic.

I would like to know the reasons for not giving it, in an non RSI situation,

[stanman1968]

Some would say for very short 10-15 min. cases, or if a concern about difficult intubation.