Effect of Succinylcholine on Postoperative Sore Throat in Hysteroscopic Surgery with Laryngeal Mask Airway (LMA): A Randomized Trial

Xiao Deng,1,2 Xin Hao,1,2 Yanmei Bi,1,2 Hao Li,1,2 Xuemei Lin1,2 1Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Xuemei Lin, Department of Anesthesiology, West China Second University Hospital, Sichuan University, 20, Section 3, Renmin South Road, Wuhou District, Chengdu, People’s Republic of China, Tel +86 15982261680, Email [email protected] Hao Li, Department of Anesthesiology, West China Second University Hospital, Sichuan University, 20, Section 3, Renmin South Road, Wuhou District, Chengdu, People’s Republic of China, Tel +86 18190963549‬‬‬‬‬‬‬‬‬‬‬‬, Email [email protected] ‬&#x202CObjective: This study aimed to evaluate the impact of succinylcholine on the incidence of postoperative sore throat (POST) in patients undergoing hysteroscopy under laryngeal mask airway (LMA)-assisted general anesthesia.Design: A prospective, randomized, double-blind clinical study.Setting: A tertiary-level hospital.Patients: Out of 154 screened patients, 144 completed the study. Participants were those undergoing daytime hysteroscopic surgery under LMA-assisted general anesthesia.Interventions: Patients were randomly assigned to receive either succinylcholine group (Group S) or 0.9% saline (Group N) during anesthesia induction. Groups S received succinylcholine at 1 mg/kg, while Group N received an equal volume of 0.9% saline.Primary and Secondary Outcomes: The primary outcome was the incidence of POST 24 hours postoperatively. Secondary outcomes included the incidence of POST in the post-anesthesia care unit (PACU) and at 6 hours postoperatively.Results: Of the 144 participants, 76 were in Groups S and 68 in Group N. The incidence of POST at 24 hours was significantly higher in Group S compared to Group N (57.90% vs 29.40%, P = 0.001). Additionally, the LMA insertion time was shorter in Group S [34.00 (28.50– 40.00) vs 36.00 (30.00– 50.00), P = 0.048], and LMA insertion conditions were improved in Group S (Group S vs N: 76/0/0 vs 48/18/2, P < 0.001). Binary logistics regression analysis, adjusted for age, revealed that the risk of POST was approximately 2.62 times higher in Group S compared to Group N (OR:2.62, 95% CI: 1.27– 5.40, P = 0.009).Conclusion: The administration of succinylcholine (1 mg/kg) during LMA-assisted general anesthesia was associated with an increased risk of POST 24 hours postoperatively. Further longitudinal research with extended follow-up is warranted to explore the relationship between succinylcholine-induced myalgia and POST development.Trial Registration Number: ChiCTR2200056918.Keywords: laryngeal mask airway, postoperative sore throat, sore throat, succinylcholine