Succinylcholine: Normal K increase
Last updated: 03/06/2015
Normal muscle releases enough potassium during succinylcholine-induced depolarization to raise serum potassium by ~ 0.5 mEq/L. Although this is usually insignificant in patients with normal baseline potassium levels, it can be life-threatening in patients with preexisting hyperkalemia or those with burn injury, massive trauma, neurological disorders/spinal cord injury (as well as in tetanus, prolonged total body immobilization, ruptured cerebral aneurysm, hemorrhagic shock with metabolic acidosis, and myopathies [eg, Duchenne’s dystrophy])
In non-renal failure patients, induction with SCh increased [K+] by 0.4 mEq/ and by 0.09 mEq/L. Schow et al. reviewed 40,000 anesthetics at Duke University Medical Center, and found 38 cases in which SCh was used with a starting potassium > 5.5 mEq/L. No fatalities or arrhythmias occurred,and the authors estimated that the maximal risk of an event was 7.9% or less.
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