Effect of thiopental and succinylcholine on serum potassium concentrations in children.

@article{Dierdorf1984EffectOT,
  title={Effect of thiopental and succinylcholine on serum potassium concentrations in children.},
  author={Stephen F. Dierdorf and William L. McNiece and T M Wolfe and Chalapathi C. Rao and G. Krishna and Lynda J. Means and Kenneth A. Haselby},
  journal={Anesthesia and analgesia},
  year={1984},
  volume={63 12},
  pages={
          1136-8
        }
}
Succinylcholine increases serum potassium levels in normal adults by 0.25-0.8 mEq/L (1,2). The magnitude of the increase in potassium is decreased when thiopental or methohexital are used for induction of anesthesia (3,4). Pretreatment with diazepam, hexafluorenium, pancuronium, or fazadinium also prevents succinylcholine-induced serum increases in potassium (2,5-7). Henning and Bush found that after halothane induction of anesthesia, succinylcholine increased serum potassium by a mean of 0.45… 
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References

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TLDR
Individual children in each group had significant increases in serum potassium, but this phenomenon was less common than has been reported in adults and changes could not be related to the presence or degree of muscular fasciculations.
Influence of Pancuronium on Potassium Efflux Produced By Succinylcholine
TLDR
Pretreatment with pancuronium may play a beneficial role in patients at risk from succinylcholine hyperkalemia and was effective not only in complete prevention of serum K-elevation but also produced consistent decrease in serum K+concentration below control values.
The Source of Increased Plasma Potassium Following Succinylcholine
TLDR
These findings suggest that the rise in potassium is due to muscle trauma induced by the relaxant during the period of fasciculation and this is confirmed by an increase in creatine phosphokinase enzyme activity.
Effects of Diazepam on Succinylcholine‐Induced Myalgia, Potassium Increase, Creatine Phosphokinase Elevation, and Relaxation
TLDR
It was concluded that diazepam had several advantages over d-tubocurarine in the prevention of succinylcholine-induced muscle pain.
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TLDR
Serum potassium levels showed a significant decrease after reaching the first surgical plane, and after the administration of the depolarizing agent suxamethonium serum potassium levels increased significantly more in the two halothane groups than in the thiopentone group.
The influence of fazadinium on the potassium efflux produced by succinylcholine
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TLDR
Results show that pre-treatment with fazadinium 0.075 mg.kg-1 was effective in preventing succinylcholine-induced potassium efflux and prévenir l’hyperkaliémie causée by succinyl choline.
Variations in Serum Potassium and Serum Cholinesterase Activity After Induction with Althesin®‐Suxamethonium and Thiopentone‐Suxamethonium
TLDR
A significant fall in serum potassium after induction of anaesthesia and a significant increase after suxamethonium with both agents are found, but there are no significant differences between the two agents.
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TLDR
Though SCh induces a small release of K+ in normal muscle, it produces a potentially lethal efflux in the presence of increased sensitivity, and this K+-releasing action of SCh persists for 2 to 3 months in patients who have sustained burns or trauma, and perhaps 3 to 6 months in Patients with upper motor neuron lesions.
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TLDR
The results obtained in the present study re-emphasize serum potassium concentration is directly proportional to arterial carbon dioxide tension, and that for every 10 torr decrease in PaCO2 there is a concomitant 0.5 mEq/L decrease in potassium.
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TLDR
In summary, one should be aware that hyperventilation and hypokalaemia occur frequently in the operating room under ordinary clinical conditions and should cause consideration of more aggressive attempts to maintain normocarbia and to use supplemental potassium during anaesthesia, particularly in patients with cardiac disease.
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