How is succinylcholine toxicity treated?
Primary treatment and intervention for succinylcholine toxicity are airway maintenance and respiratory support sufficient for the patient to maintain adequate oxygenation until the drug is metabolized and the patient can maintain adequate oxygenation and ventilation without mechanical support.
How do you reverse the effects of succinylcholine?
Sugammadex can reverse profound blockade and can be given for immediate reversal and its use would avoid the potentially serious adverse effects of the currently used agent, succinylcholine. Also, sugammadex can reverse NMB more quickly and predictably than existing agents.
What is succinylcholine antidote?
Dantrolene is an effective antidote.
What therapy is succinylcholine used for?
Succinylcholine is a skeletal muscle relaxant for intravenous (IV) administration indicated as an adjunct to general anesthesia, to facilitate tracheal intubation, and to provide skeletal muscle relaxation during surgery or mechanical ventilation.
Do you need to reverse succinylcholine?
It should always be reversed to prevent diplopia, laryngeal weakness, atelectasis, CO2 retention and respiratory acidosis. The diplopia contributes to post-operative nausea and vomiting (PONV), and the CO2 retention and respiratory acidosis lead to delayed emergences at the end of surgery.
Does neostigmine work on succinylcholine?
It is concluded that succinylcholine-induced phase II block can be safely and rapidly antagonized with neostigmine.
Why does succinylcholine cause muscle pain?
The plasma potassium increases to a higher level in patients who develop succinylcholine pains than in those who do not . During the fasciculations produced by succinylcholine, muscle fibre damage gives rise to both the hyperkalaemia and the subsequent muscle pains .
Can succinylcholine be reversed by neostigmine?
Reversal is possible with neostigmine only after roughly 30 min of NMBA administration depending upon the train-of-four ratio (TOFr).
How is succinylcholine metabolized?
Succinylcholine is rapidly metabolized by plasma cholinesterase in the bloodstream to succinylmonocholine, which is then further hydrolyzed (albeit more slowly) to succinic acid and choline. Approximately 10% of an administered dose is excreted unchanged in the urine.
What is the role of succinylcholine in the treatment of myalgia?
In situations where succinylcholine is used because of its superiority in providing fast and good intubating conditions, clinicians can treat those who are at greatest risk of developing myalgia. Combining two agents may prove to be the most useful method for reducing the incidence of fasciculations and myalgia.
Can rocuronium pre-treat succinylcholine-induced myalgia?
A rapid precurarisation technique using rocuronium, with a pretreatment dose of 0.1 mg.kg −1 given 60 s before propofol, was effective in decreasing postoperative myalgia [ 34 ]. Nondepolarising neuromuscular blockers can affect the desirable neuromuscular effects of succinylcholine.
What is the incidence of succinylcholine-induced myalgia in the US?
The reported incidence of succinylcholine-induced myalgia ranges from 1.5 to 89% [ 3, 4 ]. The most commonly quoted figure is around 50%. The duration of the discomfort is highly variable.
Is succinylcholine safe to use in clinical practice?
However, as long as succinylcholine is used in daily clinical practice, 67 there is a need for an effective treatment against this bothersome side effect, and this may explain the large number of published trials dealing with this subject.