Changes in serum potassium, calcium and creatine kinase following suxamethonium administration in children with and without strabismus

Abstract

The immediate changes in serum potassium and calcium and 2 4 h changes in creatine kinase (CK) following suxamethonium administration were compared in children undergoing strabismus repair or tonsillectomy following induction of anaesthesia with thiopentone or halothane. A separate group of children were anaesthetized with isoflurane and did not receive suxamethonium.There was a sigruficant increase (P < 0.05) in serum potassium of 0.26 and 0.56 mmol.l-' following halothane-suxamethonium induction and a sigruficant decrease ( P < 0.05) of 0.35 and 0.13 mmol.1-' after thiopentone-suxamethonium induction in the strabismus and tonsillectomy groups respectively. There was an increase in the 24 h CK values of 624 and 694 u.1-I (P < 0.05) in patients receiving halothane-swamethonium induction and of 43 (NS) and 247 u.1-I (P < 0.05) in patients receiving thiopentone-suxamethonium induction in the strabismus and tonsillectomy groups respectively. Suxamethonium administration was associated with a small but sometimes sigruficant ( P < 0.05) decrease in total serum calcium concentrations (0.036 to 0.049 mmol-1-'). Changes in all indices were minimal in children anaesthetized with isoflurane. It is concluded that the administration of halothane and suxamethonium is the main cause for the changes in serum potassium and CK and not the presence of strabismus.

Neuromuscular blocking agents in children

“…agents. The increase in serum creatine kinase levels is not different in children requiring strabismus surgery or tonsillectomy (McLoughlin et al 1991).…”