Succinylcholine induces a small increase in serum K^+(0.3∼0.5 mEq/l) in normal patients, but it may produce fatal increases in sensitive conditions, including severs burn, massive trauma, tetanus and neuromuscular disorders.
Recently, interest has ...
Succinylcholine induces a small increase in serum K^+(0.3∼0.5 mEq/l) in normal patients, but it may produce fatal increases in sensitive conditions, including severs burn, massive trauma, tetanus and neuromuscular disorders.
Recently, interest has been focussed on the role of the adrenergic system in extrarenal potassium homeostasis. Accordin to this concept, beta-adrenergic stimulation enhances and conversely a blockade impairs celluar uptake of potassium. Meanwhile propranolol, a beta-adrenergic blocker, is an increasingly, common drug among surgical patients.
Therefore, the present experiment was carried out on 66 patients in order to determine whether propranolol augments or prolongs the increases in serum K^+ following succinylcholine injection(2 mg/kg, I.V.). Serum K^+ and NaA^+ levels were measured just prior to induction and at 3,5,10,30,60,90 minutes following succinylcholine administration.
The patients were divided into three groups:
Group 1; 26 patients without propranolol treatment.
Group 2; 20 patients pretreat with divided doses of propranolol(320 mg b.i.d. p.o.). and
Group 3: 20 patients on chronic propranolol therapy.
The results were as follows.
1) Baseline K^+ values were significantly higher in propranolol treated patients(Groups 2 and 3) than in non-treadted patients(Group 1).
2) The magnitude of maximum increases in serum K^+ following succinylcholine was 0.19 mEq/l, 0.16 mEq/l and 0.21 mEq/l in Groups 1, 2 and 3, respectively.
3) The time to peak increases in K^+ was 30 min, 5 min and 3 min following succiny lcholine in Groups 1, 2 and 3, respectively.
4) Serum Na^+ decreased singificantly following succinylcholine administration in all groups, but there was no significant difference among the groups at other ives. These results indicate that propranolol neither augments nor prolongs increases in serum K^+ following succinylcholine injection. Thus succiny lcholine can be used safely in the presence of a beta-adrengic blockade.