Chapter: Clinical Cases in Anesthesia : Depolarizing Neuromuscular Blockade
What are the contraindications to succinylcholine administration?
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.
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