***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: STUDY OBJECTIVE To determine the dose of succinylcholine during inhalation induction of a patient . DESIGN ED Prospect i ve , double-blind , r and omized study . SETTING Operating room of a university hospital . PATIENTS 180 adult , ASA physical status 1 and 2 patients with a suspected difficult airway , who were scheduled for surgery . INTERVENTIONS Nonpremedicated patients were anesthetized with inhalation of 8 % sevoflurane , followed by succinylcholine . Group 1 received intravenous ( IV ) succinylcholine 0.3 mg/kg , Group 2 had IV succinylcholine 0.6 mg/kg , and Group 3 was given IV succinylcholine 1.0 mg/kg .  Direct laryngoscopy and tracheal intubation were performed after onset of succinylcholine . MEASUREMENTS Intubation conditions were scored as excellent , good , or poor . The recovery time of spontaneous respiration , end-tidal carbon dioxide partial pressure ( PETCO2 ) , and pulse oxygen saturation ( SpO2 ) were recorded . MAIN RESULTS Acceptable conditions ( excellent and good ) for intubation were rated in 80 % of Group 1 patients ( 0.3 mg/kg succhinylcholine ) , 91.7 % of Group 2 patients ( 0.6 mg/kg ) , and 93.3 % of Group 3 patients ( 1.0 mg/kg ) , respectively . Intubation scores were similar in Groups 2 and 3 , and were significantly higher than in Group 1 patients ( 0.3 mg ; P < 0.01 ) . Time to recovery of spontaneous respiration in Group 3 was significantly prolonged compared with Groups 1 and 2 ( 238 ± 59 sec vs 132 ± 43 sec , P < 0.001 ; 238 ± 59 sec vs 151 ± 47 sec , P < 0.001 , respectively ) . SpO2 in Group 3 did not differ significantly from Group 1 and 2 values . However , PETCO2 in Group 3 was significantly higher than in Groups 1 or 2 . CONCLUSIONS Succinylcholine at a dose of 0.6 mg/kg IV provided intubation conditions similar to succinylcholine at 1.0 mg/kg IV , and recovery of spontaneous respiration following a 0.6 mg/kg dose of succinylcholine was significantly shorter We have studied the effectiveness and sequelae of low-dose suxamethonium in 60 day-case oral surgery patients requiring nasal intubation . Anaesthesia was induced with propofol and alfentanil ;  60 patients were allocated r and omly to three groups of 20 patients and received no suxamethonium , suxamethonium 0.25 mg kg-1 or 0.5 mg kg-1 . All patients received i.v . fentanyl and diclofenac 100 mg rectally for analgesia . Good intubating conditions were produced in all 20 patients receiving suxamethonium 0.25 mg kg-1 , in 19 patients receiving suxamethonium 0.5 mg kg-1 and in 11 patients not receiving a neuromuscular blocker . The incidence of postoperative myalgia after suxamethonium 0.25 mg kg-1 ( 20 % ) did not differ significantly from the incidence after propofol and alfentanil alone ( 28 % ) Succinylcholine 1.0 mg/kg usually produces excellent tracheal intubation conditions in 60 s. Recovery of respiratory muscle function after this dose , however , is not fast enough to forestall oxyhemoglobin desaturation when ventilation can not be assisted . In this study , we investigated whether smaller doses of succinylcholine can produce satisfactory intubation conditions fast enough to allow rapid sequence induction with a shorter recovery time . Anesthesia was induced with fentanyl/propofol and maintained by propofol infusion and N2O in O2 . After the induction , 115 patients were r and omly allocated to five groups according to the dose of succinylcholine ( 0.3 mg/kg , 0.4 mg/kg , 0.5 mg/kg , 0.6 mg/kg , or 1.0 mg/kg ) . Evoked adductor pollicis responses to continuous 1-Hz supramaximal ulnar nerve stimulation were recorded using acceleromyography .  Tracheal intubation conditions were grade d 60 s after succinylcholine administration . Onset time , maximal twitch depression , time to initial twitch detection after paralysis , and to 10 % , 25 % , 50 % , and 90 % twitch height recovery were recorded . Time to initial diaphragmatic movement as well as time to resumption of regular spontaneous respiratory movements were calculated . Onset times ranged between 82 s and 52 s , decreasing with increasing doses of succinylcholine but not differing between 0.6 and 1 mg/kg . Maximum twitch depression was similar after 0.5 , 0.6 , and 1 mg/kg ( 98.2%–100 % ) . Recoveries of twitch height and apnea time were dose-dependent . Intubation conditions were often unacceptable after 0.3- and 0.4-mg/kg doses . Acceptable intubation conditions were achieved in all patients receiving a 0.5 , 0.6 , and 1 mg/kg dose of succinylcholine .  Intubation conditions in patients receiving 0.6 and 1 mg/kg were identical , whereas times to T1 = 50 % and 90 % and time to regular spontaneous reservoir bag movements were significantly shorter in the 0.6-mg/kg dose group ( 5.78 , 7.25 , and 4.0 min , respectively ) versus patients receiving 1 mg/kg ( 8.55 , 10.54 , and 6.16 min , respectively ) . The use of 0.5 to 0.6 mg/kg of succinylcholine can produce acceptable intubation conditions 60 s after administration . The conditions achieved after 0.6 mg/kg are similar to those after 1.0 mg/kg . These smaller doses are associated with faster twitch recovery and shorter apnea time Background : The aim of this prospect i ve , r and omized , double-blind study was to compare tracheal intubating conditions and the duration of apnoea following administration of 0.4 , 0.6 and 1.0 mg/kg of succinylcholine during simulated rapid sequence induction of anaesthesia . Methods : Anaesthesia was induced with fentanyl 2 μg/kg and propofol 2 mg/kg followed by application of cricoid pressure . Patients were r and omly allocated to three groups according to the dose of succinylcholine administered ( 0.4 , 0.6 or 1.0 mg/kg ) . Intubating conditions were assessed at 60 s after succinylcholine administration . Time to first diaphragmatic contraction ( apnoea time ) and time to resumption of regular spontaneous breathing were noted . Results : Excellent intubating conditions were obtained in 52.4 % , 95.7 % and 100 % of the patients after 0.4 , 0.6 and 1.0 mg/kg succinylcholine , respectively ; P<0.001 . Acceptable intubating conditions ( excellent and good grade combined ) were obtained in 66.7 % , 100 % and 100 % of the patients after 0.4 , 0.6 and 1.0 mg/ kg succinylcholine , respectively ; P<0.001 . Apnoea time and resumption of regular spontaneous breathing were dose-dependent . Apnoea time was 3.8±1.1 min , 4.3±0.9 min and 8.2±3.4 min in groups 0.4 , 0.6 and 1.0 mg/kg , respectively ; P<0.001 . Time to regular spontaneous breathing was 5.3±1.2 min , 5.5±1.1 min and 8.9±3.5 min in groups 0.4 , 0.6 and 1.0 mg/kg , respectively ; P<0.001 . Conclusion : A dose of 0.6 mg/kg succinylcholine can be used for rapid sequence induction of anaesthesia as it provides acceptable intubating conditions with a shorter apnoea time compared with a dose of 1 mg/kg Background The usually cited “ intubation dose ” of succinylcholine is 1.0 mg/kg . In the majority of patients , this dose will produce apnea of sufficient duration that significant hemoglobin desaturation may occur before neuromuscular recovery takes place in those whose ventilation is not assisted . This study was undertaken to examine the extent to which reducing this dose would decrease the duration of action of succinylcholine . Methods During stable desflurane/oxygen/opioid anesthesia and after adequate twitch stabilization ,  neuromuscular function  was recorded with an acceleromyographic monitor . Supramaximal stimuli were delivered at 0.10 Hz . Patients  received 0.40 , 0.60 , or 1.0 mg/kg succinylcholine , and twitch height was monitored for at least 20 min thereafter . Results The onset times to maximal effect were 105 ± 23 s , 81 ± 19 s , and 71 ± 22 s , respectively . The lowest dose ( 0.40 mg/kg ) did not reliably produce 100 % twitch depression . The times to 90 % twitch recovery at the adductor pollicis in the three groups were 6.6 ± 1.5 min , 7.6 ± 1.6 min , and 9.3 ± 1.2 min , respectively . Conclusions Reducing the dose of succinylcholine from 1.0 mg/kg to 0.60 mg/kg shortens the duration of effect at the adductor pollicis by more than 90 s. The authors believe that even this modest decrease in the duration of drug-induced paralysis is often worth pursuing Background The authors reappraised the conventional wisdom that the intubating dose of succinylcholine must be 1.0 mg/kg and attempted to define the lower range of succinylcholine doses that provide acceptable intubation conditions in 95 % of patients within 60 s. Methods This prospect i ve , r and omized , double-blind study involved 200 patients . Anesthesia was induced with 2 & mgr;g/kg fentanyl and 2 mg/kg propofol . After loss of consciousness , patients were r and omly allocated to receive 0.3 , 0.5 , or 1.0 mg/kg succinylcholine or saline ( control group ) . Tracheal intubation was performed 60 s later . A blinded investigator performed all laryngoscopies and also grade d intubating conditions . Results Intubating conditions were acceptable ( excellent plus good grade combined ) in 30 % , 92 % , 94 % , and 98 % of patients after 0.0 , 0.3 , 0.5 , and 1.0 mg/kg succinylcholine , respectively . The incidence of acceptable intubating conditions was significantly greater ( P < 0.05 ) in patients receiving  succinylcholine  compared with those in the control group but was not different among the different succinylcholine dose groups . The calculated doses of succinylcholine ( and their 95 % confidence intervals ) that were required to achieve acceptable intubating conditions in 90 % and 95 % of patients at 60 s were 0.24 ( 0.19–0.31 ) mg/kg and 0.56 ( 0.43–0.73 ) mg/kg , respectively . Conclusions The use of 1.0 mg/kg of succinylcholine may be excessive if the goal is to achieve acceptable intubating conditions within 60 s. Comparable intubating conditions were achieved after 0.3 , 0.5 , or 1.0 mg/kg succinylcholine . In a rapid-sequence induction , 95 % of patients with normal airway anatomy anesthetized with 2 & mgr;g/kg fentanyl and 2 mg/kg propofol should have acceptable intubating conditions at 60 s after 0.56 mg/kg succinylcholine . Reducing the dose of succinylcholine should allow a more rapid return of spontaneous respiration and airway reflexes In this prospect i ve , r and omized , double-blind , placebo-controlled study , we attempted to define the dose of succinylcholine that provides excellent intubation conditions in patients within 60 s during simulated rapid-sequence induction of anesthesia . Anesthesia was induced in 180 patients with  2  &  mgr;g/kg fentanyl and 2 mg/kg propofol . After loss of consciousness , patients were r and omly allocated to receive 0.3 , 0.5 , 1.0 , 1.5 , or 2.0 mg/kg succinylcholine or saline solution ( control group ) . Tracheal intubation was performed 60 s later . A blinded investigator performed all laryngoscopies and grade d intubating conditions . Intubating conditions were excellent in 0.0 % , 43.3 % , 60.0 % , 63.3 % , 80.0 % , and 86.7 % of patients after 0.0 , 0.3 , 0.5 , 1.0 , 1.5 , and 2.0 
    Output:
    
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 data base with these regimens is weak and apnoea times remain unknown .