Succinylcholine "the gold standard" for rapid-sequence induction of anesthesia.

The neuromuscular effects of succinylcholine (SCh) were described1 by Bovet 1949. The drug was introduced into clinical anesthesia in the United States by Foldes et al 1952, who stated that “the advantages of succinylcholine as a muscular relaxant in anesthesiology far outweighed its disadvantages”2. Even today in the 6th decade of its use, SCh, despite complications, survived as the “gold standard” for rapid-sequence induction of anesthesia (RSI), against which other relaxants are compared3. The drug survived, despite the reported complications, because of the unique triad characterizing its neuromuscular block i.e. rapid onset, profound relaxation and short duration, which makes succinylcholine the drug of choice for rapid-sequence induction (RSI) of anesthesia in patients with full stomach, as well as the preferred relaxant for tracheal intubation in patients with a predicted difficult airway3-5.