Suxamethonium-induced hyperkalaemia 6 weeks after chemoradiotherapy in a patient with rectal carcinoma.

  title={Suxamethonium-induced hyperkalaemia 6 weeks after chemoradiotherapy in a patient with rectal carcinoma.},
  author={Elena J. Holak and Julie Faulkner Connelly and Paul S. Pagel},
  journal={British journal of anaesthesia},
  volume={98 6},
Suxamethonium causes an efflux of potassium (K+) ions by depolarizing acetylcholine receptors within the neuromuscular junction and produces a transient, small rise in serum K+ concentration in normal individuals that is usually of little clinical importance. Despite the clear efficacy and relative safety of suxamethonium in many patients, anaesthetists are also very aware that acute, severe hyperkalaemia resulting in important cardiovascular sequelae (e.g. malignant ventricular arrhythmias… 
6 Citations
Can Succinylcholine be Used Safely in Severely Burn Patients
Data taken in the context of a compelling case forrapid intubating condition suggest safety in succinylcholineuse in the patients with acute burn.
Adverse events in radiation oncology: A case series from wake up safe, the pediatric anesthesia quality improvement initiative
This case series aims to review a multicenter registry of significant adverse events and make recommendations for improved care of radiation therapy in pediatric patients.


Pathophysiology of hyperkalemia induced by succinylcholine.
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.
Succinylcholine-induced Hyperkalemia in Acquired Pathologic States: Etiologic Factors and Molecular Mechanisms
The nicotinic (neuronal) α7 acetylcholine receptors, recently described to be expressed in muscle also, can be depolarized not only by acetyl choline and succinylcholine but also by choline, persistently, and possibly play a critical role in the hyperkalemic response to succinyl choline in patients with up-regulated AChRs.
Suxamethonium and Hyperkalaemia
  • S. Yentis
  • Medicine
    Anaesthesia and intensive care
  • 1990
The normal hyperkalaemic response to suxamethonium, the factors affecting it, the conditions in which it may be exaggerated, and the periods of high risk are described.
Succinylcholine‐Induced Hyperkalemia in the Rat following Radiation Injury to Muscle
During anesthetic preparation of a patient who had received routine radiation therapy for sarcoma of the leg, cardiac collapse occurred following succinylcholine (SCh) administration. Experiments
Changes in plasma potassium concentration after depolarizing blockers in anaesthetized man.
Changes in plasma potassium concentration after administration of depolarizing neuromuscular blockers were measured in patients during halothane-nitrous oxide anaesthesia, with there being a direct correlation between degree of rise and time since injury.
Succinylcholine-induced hyperkalemia in a patient with mucositis secondary to chemotherapy
It is believed that mucositis was a contributing factor to this case of fatal hyperkalemia after administration of succinylcholine, with a mechanism similar to that reported with thermal injury.
Can Succinylcholine Be Used Safely in Hyperkalemic Patients?
Safety in succinylcholine use in patients with modest hyperkalemia is suggested, taken in the context of a compelling case for rapid intubating conditions without long-term paralysis.
The Effect of Repeated Doses of Succinylcholine on Serum Potassium in Patients with Renal Failure
The effect of 1 mg/kg of succinylcholine IV in repeated doses on serum potassium (K+) was studied in patients with renal failure and it was concluded that succinylCholine administered repeatedly at this dosage is not contraindicated in patientsWith renal failure.
Alterations in Skeletal Muscle after X-Irradiation and their Similarity to Changes in Muscular Dystrophy
It seems likely that the creatine and other amino-acids and the aldolase were lost, in large part, by skeletal muscle and it occurred to us that subtle in vivo changes in muscle after irradiation might have been overlooked.