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Abstract：
The evidence base for the widely accepted standard regimen of succinylcholine for rapid sequence induction (1.0 mg kg- 1) remains unclear.
We performed a systematic review and meta-analysis of randomized trials comparing any succinylcholine regimen with the standard regimen (1.0 mg kg- 1) and reporting on intubating conditions and/or apnoea times. Results were expressed as absolute risk differences (ARD) for dichotomous data and mean differences (MD) for continuous data.
We retrieved six trials with relevant data of 864 patients (ASA 1 or 2, aged 18-65 years, body mass index < 30 kg m- 2). Four regimens (0.3, 0.4, 0.5, 0.6 mg kg- 1) were compared with 1.0 mg kg- 1 in at least three trials each, and three (0.8, 1.5, 2 mg kg- 1) in one each. With 0.3 to 0.5 mg kg- 1, the likelihood of excellent intubating conditions was significantly decreased (ARD - 22% to - 67%). With 0.3 and 0.4 mg kg- 1, but not with 0.5, 0.6, 0.8, 1.5 and 2.0 mg kg- 1, the likelihood of unacceptable intubating conditions was significantly increased (ARD + 22% and + 32%, respectively). With 2.0 mg kg- 1, but not with 0.8 or 1.5 mg kg- 1, the likelihood of excellent intubating conditions was significantly increased (ARD + 23%). Apnoea times were significantly shorter with regimens ≤0.8 mg kg- 1 (MD - 1.0 to - 3.4 min) but were not reported with 1.5 or 2.0 mg kg- 1.
With succinylcholine regimens ≤0.5 mg kg- 1, excellent intubating conditions are less likely and apnoea times are shorter, compared with 1 mg kg- 1. With 0.3 and 0.4 mg kg- 1, unacceptable intubating conditions are more common. Succinylcholine 1.5 mg kg- 1 does not produce more often excellent conditions compared with 1 mg kg- 1, while 2.0 mg kg- 1 does, but the database with these regimens is weak and apnoea times remain unknown. Limited information size and strong statistical heterogeneity decrease the certainty of the evidence.
We performed a systematic review and meta-analysis of randomized trials comparing any succinylcholine regimen with the standard regimen (1.0 mg kg- 1) and reporting on intubating conditions and/or apnoea times. Results were expressed as absolute risk differences (ARD) for dichotomous data and mean differences (MD) for continuous data.
We retrieved six trials with relevant data of 864 patients (ASA 1 or 2, aged 18-65 years, body mass index < 30 kg m- 2). Four regimens (0.3, 0.4, 0.5, 0.6 mg kg- 1) were compared with 1.0 mg kg- 1 in at least three trials each, and three (0.8, 1.5, 2 mg kg- 1) in one each. With 0.3 to 0.5 mg kg- 1, the likelihood of excellent intubating conditions was significantly decreased (ARD - 22% to - 67%). With 0.3 and 0.4 mg kg- 1, but not with 0.5, 0.6, 0.8, 1.5 and 2.0 mg kg- 1, the likelihood of unacceptable intubating conditions was significantly increased (ARD + 22% and + 32%, respectively). With 2.0 mg kg- 1, but not with 0.8 or 1.5 mg kg- 1, the likelihood of excellent intubating conditions was significantly increased (ARD + 23%). Apnoea times were significantly shorter with regimens ≤0.8 mg kg- 1 (MD - 1.0 to - 3.4 min) but were not reported with 1.5 or 2.0 mg kg- 1.
With succinylcholine regimens ≤0.5 mg kg- 1, excellent intubating conditions are less likely and apnoea times are shorter, compared with 1 mg kg- 1. With 0.3 and 0.4 mg kg- 1, unacceptable intubating conditions are more common. Succinylcholine 1.5 mg kg- 1 does not produce more often excellent conditions compared with 1 mg kg- 1, while 2.0 mg kg- 1 does, but the database with these regimens is weak and apnoea times remain unknown. Limited information size and strong statistical heterogeneity decrease the certainty of the evidence.
摘要：
用于快速序列诱导的琥珀酰胆碱标准方案（1.0mgkg-1）的证据基础尚不清楚。
我们对随机试验进行了系统评价和荟萃分析，比较了任何琥珀酰胆碱方案与标准方案（1.0mgkg-1），并报告了插管条件和/或呼吸暂停时间。结果表示为二分数据的绝对风险差异（ARD）和连续数据的平均差异（MD）。
我们检索了六个试验，其中864名患者的相关数据（ASA1或2，年龄18-65岁，体重指数<30kgm-2)。四个方案（0.3，0.4，0.5，0.6mgkg-1）与1.0mgkg-1在至少三个试验中进行了比较，和三个(0.8、1.5、2毫克千克-1)各一个。使用0.3至0.5mgkg-1时，良好插管条件的可能性显着降低（ARD-22％至-67％）。使用0.3和0.4mgkg-1，但不使用0.5、0.6、0.8、1.5和2.0mgkg-1，出现不可接受插管条件的可能性显着增加（ARD+22%和+32%，分别)。使用2.0mgkg-1，但不使用0.8或1.5mgkg-1，出色插管条件的可能性显着增加（ARD23％）。方案≤0.8mgkg-1（MD-1.0至-3.4min）时，呼吸暂停时间明显缩短，但未报告1.5或2.0mgkg-1时的呼吸暂停时间。
琥珀酰胆碱方案≤0.5mgkg-1时，良好的插管条件不太可能，并且呼吸暂停时间更短，与1毫克千克-1相比。对于0.3和0.4mgkg-1,不可接受的插管条件更常见。与1mgkg-1相比，琥珀酰胆碱1.5mgkg-1不会产生更多的优良条件，而2.0mgkg-1确实如此，但是这些方案的数据库很弱，呼吸暂停时间仍然未知。有限的信息规模和强烈的统计异质性降低了证据的确定性。
我们对随机试验进行了系统评价和荟萃分析，比较了任何琥珀酰胆碱方案与标准方案（1.0mgkg-1），并报告了插管条件和/或呼吸暂停时间。结果表示为二分数据的绝对风险差异（ARD）和连续数据的平均差异（MD）。
我们检索了六个试验，其中864名患者的相关数据（ASA1或2，年龄18-65岁，体重指数<30kgm-2)。四个方案（0.3，0.4，0.5，0.6mgkg-1）与1.0mgkg-1在至少三个试验中进行了比较，和三个(0.8、1.5、2毫克千克-1)各一个。使用0.3至0.5mgkg-1时，良好插管条件的可能性显着降低（ARD-22％至-67％）。使用0.3和0.4mgkg-1，但不使用0.5、0.6、0.8、1.5和2.0mgkg-1，出现不可接受插管条件的可能性显着增加（ARD+22%和+32%，分别)。使用2.0mgkg-1，但不使用0.8或1.5mgkg-1，出色插管条件的可能性显着增加（ARD23％）。方案≤0.8mgkg-1（MD-1.0至-3.4min）时，呼吸暂停时间明显缩短，但未报告1.5或2.0mgkg-1时的呼吸暂停时间。
琥珀酰胆碱方案≤0.5mgkg-1时，良好的插管条件不太可能，并且呼吸暂停时间更短，与1毫克千克-1相比。对于0.3和0.4mgkg-1,不可接受的插管条件更常见。与1mgkg-1相比，琥珀酰胆碱1.5mgkg-1不会产生更多的优良条件，而2.0mgkg-1确实如此，但是这些方案的数据库很弱，呼吸暂停时间仍然未知。有限的信息规模和强烈的统计异质性降低了证据的确定性。
