Succinyl Choline
Trade names:
Scoline
Class: Depolarising muscle relaxants
Pregnancy:
(Category C) Action:
An ultra short-acting depolarizing
skeletal muscle relaxant, Succinyl Choline bonds with motor endplate
cholinergic receptors to produce depolarization (perceived as fasciculation).
The neuromuscular block remains as long as sufficient quantities of Succinyl
Choline remain, and is characterized by a flaccid paralysis.
Uses:
Succinyl Choline chloride is indicated
as an adjunct to general anesthesia, to facilitate tracheal intubation, and to
provide skeletal muscle relaxation during surgery or mechanical ventilation,
and to reduce the intensity of muscle contractions associated with electro- or
pharmacological- induced convulsions.
Dose:
by intravenous injection, initially 1 mg/kg;
maintenance, usually 0.5–1 mg/kg at 5– 10 minute intervals; max. 500 mg/hour;
neonate and infant, 2 mg/kg; child, 1 mg/kg
By intravenous infusion of a solution
containing 1–2 mg/mL 2.5–4 mg/minute; max. 500 mg/hour;
By intramuscular injection, INFANT up to 4–5
mg/kg; CHILD up to 4 mg/kg; max. 150 mg
Contraindications:
Succinyl Choline is contraindicated in
persons with personal or familial history of malignant hyperthermia, skeletal
muscle myopathies, and known hypersensitivity to the drug.
Side effects:
Adverse reactions to Succinyl Choline
consist primarily of an extension of its pharmacological actions. Succinyl
Choline causes profound muscle relaxation resulting in respiratory depression
to the point of apnea; this effect may be prolonged. Hypersensitivity
reactions, including anaphylaxis, may occur in rare instances. The following
additional adverse reactions have been reported: cardiac arrest, malignant
hyperthermia, arrhythmias, bradycardia, tachycardia, hypertension, hypotension,
hyperkalemia, prolonged respiratory depression or apnea, increased intraocular
pressure, muscle fasciculation, jaw rigidity, postoperative muscle pain,
rhabdomyolysis with possible myoglobinuric acute renal failure, excessive
salivation, and rash.
Nursing
considerations:
Succinylcholine should not be used if
organophosphate agents have been given or applied recently.
Succinylcholine chloride does not have
analgesic effects; and should be used with appropriate
analgesic/sedative/anesthetic agents. Be prepared to administer oxygen and
artificial respiration.
Facilities for resuscitation and treatment of
shock should be available.
