Comparison of muscle paralysis after intravenous and intraosseous administration of succinylcholine

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“Succinylcholine can be effectively administered via the IO route. However, an increased dose may be necessary when administering succinylcholine via the IO route to achieve the same rapid onset as standard IV dosing.”

Reference:

Loughren, M.J., Kilbourn, J., Worth, K., Burgert, J., Gegel, B. and Johnson, D. (2014) Comparison of muscle paralysis after intravenous and intraosseous administration of succinylcholine in Swine. Journal of Special Operations Medicine. 14(2), p.35-7.

Abstract:

Aim: To compare the onset and duration of intravenous (IV) and intraosseous (IO) administration of succinylcholine in swine.

Methods: Electromyographic (EMG) amplitudes were used to characterize muscle paralysis following administration of succinylcholine via the IV or IO route in four Yorkshire-cross swine.

Results: The onset of action of succinylcholine was statistically longer after IO administration (0.97 ± 0.40) compared with IV administration (0.55 ± 0.26) (p = .048). Duration of action was unaffected by route of administration: IO, 11.4 ± 4.2, and IV, 12.9 ± 3.8 (p = .65).

Conclusions: Succinylcholine can be effectively administered via the IO route. However, an increased dose may be necessary when administering succinylcholine via the IO route to achieve the same rapid onset as standard IV dosing.

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