What are the contraindications to succinylcholine administration?
Contraindications to succinylcholine administration follow logically from its known side-effects.
Denervation states leading to extrajunctional receptor upregulation generally contraindicate succinylcholine after 1–3 days following nerve interruption. Uncommon neuro-muscular diseases, such as myotonia and dermatomyositis, react with sustained muscular contraction following succinylcholine administration. This defect appears to be intracellular and not at the neuromuscular junction. Such episodes can complicate ventilation and laryng-oscopy.
Recently, recommendations for the use of succinyl-choline in children have been revised. Several cases of hyperkalemic cardiac arrest in children have been attrib-uted to previously undiagnosed neuromuscular disease, including the muscular dystrophies. Therefore, succinyl-choline should only be used in children for rapid sequence induction or emergency control of the airway.