Ideal dose of Succinylcholine is 1-2 mg per kg body weight. Not 1mg per kg body weight as described in many texts. 1mg per kg provides Inadequate relaxation and discomfort in the name of safety. 2mg per kg is also safe and provides good intubation conditions. Dose of Succinylcholine shud be increased in OBESE subjects bcoz—- Pseudocholinesterase levels are high in obese. Thus Succinylcholine gets metabolized fast. The volume of distribution is high.
Difficult intubation is Common in obese. Submandibular fat, Reduced submental space etc Sleep apnea is very common. Restricted neck flexion / Extension movements due to fat around the neck, Buffalo hump, Shortened neck due to fat, etc etc. Precautions : Check potassium level before Anaesthesia. Do not hesitate to Use Blood transfusions If Succinylcholine apnea is suspected. Difficult airway is far more common than complications of…
