| Can succinylcholine be used safely in hyperkalemic patients? | |
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MedLine Citation:
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PMID: 12088954 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The use of succinylcholine in hyperkalemic patients (serum potassium >5.5 mEq/L) is often viewed as relatively contraindicated, although there are no systematic data to define what preoperative potassium level is safe. We retrospectively reviewed more than 40,000 general anesthetics administered over 70 mo in which succinylcholine was given at the induction. This search yielded 38 patients with a preoperative potassium of 5.6 mEq/L or greater. Survival of the anesthetic was 100%, and no dysrhythmias or other major morbidity were documented upon manual review of the intraoperative automated record keeper charts or the patient medical records. These data allow a 95% confidence interval assessment of maximal risk for an event of 7.9%, which is not negligible, but which almost certainly grossly overestimates the risk for patients with moderately increased potassium levels. A prospective trial to definitively assess the safety margin for succinylcholine use in hyperkalemic patients would be difficult. Therefore, these data, taken in the context of a compelling case for rapid intubating conditions without long-term paralysis, suggest safety in succinylcholine use in patients with modest hyperkalemia. IMPLICATIONS: In a review of more than 40,000 general anesthetics in which succinylcholine was given at induction, 38 patients had a preoperative potassium of 5.6 mEq/L or greater. All patients survived the anesthetic with no dysrhythmias or other major morbidity documented. Succinylcholine may be appropriate and safe for use in certain patients with moderate hyperkalemia. |
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Authors:
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Adam J Schow; David A Lubarsky; Ronald P Olson; Tong J Gan |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 95 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-06-28 Completed Date: 2002-07-23 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 119-22, table of contents Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Anesthesia* Child Child, Preschool Female Humans Hyperkalemia / complications* Infant Male Middle Aged Neuromuscular Depolarizing Agents / adverse effects* Potassium / blood Retrospective Studies Risk Assessment Succinylcholine / adverse effects* |
| Chemical | |
Reg. No./Substance:
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0/Neuromuscular Depolarizing Agents; 306-40-1/Succinylcholine; 7440-09-7/Potassium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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