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The correct dosing regimen for succinylcholine in obese patients remains controversial, and clinicians have been reluctant to administer the large doses that would be indicated by an obese patient’s total body weight. In a randomized, double-blind study, investigators compared dosing by ideal, lean, and total body weight in 45 morbidly obese patients (body-mass index >40) who did not have attributes that predict difficult intubation.
After induction of general anesthesia with fentanyl (3μg/kg of lean body weight) and propofol (2.5 mg/kg), patients were randomized to receive one of three dosing regimens of succinylcholine: 1 mg/kg of ideal body weight, 1 mg/kg of lean body weight, or 1 mg/kg of total body weight. Intubating conditions during …