To the Editor.—
Dr Phillips' answer regarding anesthesia for elective termination of pregnancy in outpatients (236:1290, 1976) leaves the impression that a succinylcholine infusion can generally be used with unassisted spontaneous ventilation. I doubt that this is the message he intended, as succinylcholine is a potent muscle relaxant, and the probability of attendant hypoventilation with its use is significant. It is true, as stated, that the succinylcholine infusion can be so regulated that the patient will not move during surgery while spontaneous breathing continues. However, under this condition of muscle weakness, the patient's tidal volume and alveolar ventilation are usually diminished. Therefore, to avoid hypoxia and hypercapnia caused by inadequate alveolar ventilation, spontaneous ventilation should be assisted or controlled during succinylcholine-induced partial muscle paralysis.Concerning the use of general anesthesia, one study has shown that the addition of the short-acting narcotic fentanyl to thiopental-nitrous oxide anesthesia for voluntary interruption of
Annis JP. Anesthesia for Elective Termination of Pregnancy. JAMA. 1976;236(26):2942–2943. doi:10.1001/jama.1976.03270270004012
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