Changes in Plasma Potassium Concentration After Depolarizing Blockers in Anaesthetized Man

Abstract

Changes in plasma potassium concentration after administration of depolarizing neuromuscular blockers were measured in patients during halothane-nitrous oxide anaesthesia. Suxamethonium 100 mg intravenously caused a peak rise of 0.55 m.equiv/1. and decamethonium 4 mg produced an elevation of similar magnitude. Injured patients had increases in potassium averaging 1.80 m.equiv/1. there being a direct correlation between degree of rise and time since injury. By giving tubocurarine 0.1 mg/kg body weight 5 minutes beforehand, the elevation in potassium caused by suxamethonium, though not by decamethonium, could be halved.

Suxamethonium-Induced Hyperkalaemia in Patients With Severe Intra-Abdominal Infections

“…In patients susceptible to suxamethonium-induced hyperkalaemia the injection of non-depolarizing muscle relaxants before the administration of suxamethonium has been shown to moderate the potassium response (Weintraub, Heisterkamp and Cooperman, 1969). Our own observations appear to support this measure.…”

“…Pancuronium 2 mg was then injected i.v. in order to control a potentially hazardous increase in serum potassium concentrations (Weintraub, Heisterkamp and Cooperman, 1969). Three to five minutes later, suxamethonium 100 mg was injected, the trachea was intubated and anaesthesia was maintained with a mixture of 70% nitrous oxide in oxygen.…”

Suxamethonium pains and early electrolyte changes

“…Minutes after suxomethoniurn 3. Average changes in plasma calcium following suxamethonium, using thiopentone (-) and Althesin…”

“…in 1954. [1][2][3][4][5] Since 1967,6 attention has been largely focused on the massive hyperkalaemia which may produce cardiac arrest in susceptible individuals. ' …”

The use of muscle relaxants in the intensive care unit

“…With the exception of the patient in whom difficult tracheal intubation is anticipated, the contraindications to succinylcholine (Table V) are primarily attributed to conditions in which its administration may cause hyperkalaemia. 23 Normally there is an increase of serum potassium of approximately 0.5 mEq. L -I due to leakage of potassium from the muscle cell during depolarization.…”