The Succinylcholine is mainly used in anesthesia to facilitate the ‘ endotracheal intubation , the mechanical ventilation and a wide range of surgical maneuvers and obstetricians . It can also be used during anticonvulsant therapy to reduce the intensity of muscle contractions.
What is succinylcholine?
Succinylcholine is muscle relaxant . It is a neuromuscular blocker , which is included in the group of “depolarizing muscle relaxants”, of which it is the progenitor. The depolarizing compounds are active principles that interrupt neuromuscular transmission , and therefore induce a partial depolarization of the motor plates of the skeletal muscles.
In this way, the tissues are unable to react to the action of the Aceticoline neurotransmitter . Succinylcholine has a shorter duration over time than principles such as Tubocurarine, Atracurium, Cisatracurium, Pipecuronium, Vancuronium and other non-depolarising muscle-salting agents, which are used in handling, as well as in minor operations. The decamethonium is another depolarizing muscle relaxant, which is part of the same group of Succinylcholine.
How is Succinylcholine taken?
Succinylcholine is marketed in the form of a preparation for injections , to be carried out intravenously .
Side effects of succinylcholine
Using this drug can elicit a wide range of side effects. Note:
- cardiovascular changes: bradycardia, cardiac arrest, cardiac arrhythmias, tachycardia, hypotension, hypertension ;
- endocrine-metabolic alterations: hyperkalemia, porphyria;
- gastrointestinal changes: excessive salivation;
- changes in kidney function: kidney failure;
- hematological changes: myoglobinemia;
- immunological changes: anaphylactoid reactions;
- musculoskeletal changes: myalgia, myasthenia gravis, increased muscle stiffness, rhabdomyolysis;
- respiratory function alterations: respiratory paralysis, apnea, bronchospasm, pulmonary edema.
Contraindications and warnings on the use of Succinylcholine
Succinylcholine should only be administered by qualified personnel .
In the case of subjects with known or presumed hypersensitivity to the product or who have shown hypersensitivity towards other neuromuscular blockers it is necessary to pay particular attention to the administration of this drug.
The succinylcholine dosage must be personalized for each patient on the basis of parameters such as age, body weight, the desired degree of muscle relaxation and the individual response of the subject. This is a valid rule for the administration of all muscle relaxants.
In the following cases the use of succinylcholine is contraindicated : hypersensitivity to the drug; malignant hyperthermia; hyperkalaemia and associated conditions; risk or presence of elevated endocular pressure (glaucoma risk); congenital myotonic diseases; musculoskeletal myopathies; hereditary plasma cholinesterase deficiency.
The pediatric patients are more likely to suffer from certain medical conditions, even undiagnosed, which puts them at increased risk of adverse events degrees. Hence, the administration of succinylcholine in children requires special attention.
Some particular states – pregnancy , puerperium , presence of tetanus, burns, serious or chronic infections, chronic debilitating diseases, malignant neoplasms, chronic anemia and malnutrition; autoimmune diseases, severe dehydration – neuromuscular blocking effects may increase .
Although succinylcholine has been shown not to cross the placental barrier , pregnant women should not be given it unless the benefit to maternal health outweighs the possible dangers to which the unborn child is exposed.