Summary
Electrocardiographic monitoring and serial plasma potassium determinations before, during, and after intravenous succinylcholine were performed for 100 clinical anaesthetics. We found that the appearance and magnitude of plasma potassium changes had no temporal relationship to the observed transient electrocardiographic abnormalities. In no instance did appreciable circulatory changes take place.
Résumé
Au cours de 100 anesthésies consécutives, nous avons présenté une étude des changements électrocardiographiques ainsi que des modifications du taux de potassium sérique à la suite ďune injection de 1.5 mg/kg de succinylcholine. Chez ces malades, nous n’avions besoin que ďun bref instant de relâchement musculaire. Nous avons observé des modifications du taux de potassium sérique mais il nous a été impossible ďétablir une relation concomittante entre les anomalies électrocardiographiques et ľapparition des modifications du taux de potassium et ľimportance de ces modifications. Les anomalies électrocardiographiques observées ont été, ďailleurs, très passagères. Nous n’avons pas observé de troubles circulatoires importants.
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References
Belin, R. P. &Karleen, C. I. Cardiac Arrest in the Burned Patient Following Succinylcholine Administration. Anesthesiology.27: 516 (1966).
Benway, R. E.;Mater, E. S.; &Jenicek, J. A. Anesthetic Management of Severely Burned Patient. Am. J. Surg.103: 677 (1962).
Houston, J. B. Serum Potassium Changes Following Succinylcholine. Personal communication (to be published).
Meyer, E. &Huegin, W. Cardiovascular Reactions to Succinylcholine. Anaesthesist.12: 65 (1963).
Bullough, J. Intermittent Suxamethonium Injections. Brit. Med. J.5124: 786 (1959).
Pedinelli, L.;Malavaud, A.; &Goinard. P.Arrêt cardiaque par Succinyl-choline, réanimé avec succès par massage trans-diaphagmatique.Lyon Chir.61: 776–778 (1965).
Gologorski, V. A. &Umanov, I. M. Studies of the Effect of Succinylcholine on Cardiac Activity. III Symposium Internationale Anaesthesiologiae (1967), pp. 120–21.
Williams, C. H.;Deutsch, S.;Linde, H. W.;Bullough, J. W.; &Dripps, R. D. Effects of Intravenously Administered Succinylcholine on Cardiac Rate, Rhythm and Arterial Blood Pressure in Anesthetized Man. Anesthesiology.22: 947 (1961).
Williams, R. T. Electrocardiographic Changes Following Repeated Injections of Decamethonium and Subsequent Injections of Succinylcholine. Canad. Anaesth. Soc. J.9: 263 (1962).
Streeton, J. A. Traumatic Haemoglobinuria Caused by Karate Exercises. Lancet.2: 191 (1967).
Eliot, R. S.;Shafer, R. B. &Gibas, M. A. Demonstration of Myoglobinemia in Football Players. Arch. Phys. Med.48: 229 (1967).
Kilburn, K. H. Muscular Origin of Elevated Plasma Potassium during Exercise. J. Appl. Physiol.21: 675 (1966).
Airaksinen, M. M. &Tammisto, T. Myoglobinuria after Intermittent Administration of Succinylcholine during Halothane Anesthesia. Clin. Pharmac. and Therap.7: 583 (1967).
Benneke, K. A. &Jarnum, S. Myoglobinuria with Acute Renal Failure Possibly Induced by Suxamethonium. Brit. J. Anaesth.36: 730 (1964).
Tammisto, T. &Airaksinen, M. M. Suxamethonium-induced Myoglobinuria. Brit. J. Anaesth.37: 464 (1965).
Dowdy, E. G. &Fabian, L. W. Ventricular Arrhythmias Induced by Succinylcholine in Digitalized Patients. Anesth. & Analg.42: 501 (1963).
Jerums, G.;Whittingham, S.; &Wilson, P. Anaphylaxis to Suxamethonium: A Case Report. Brit. J. Anaesth.39: 73 (1967).
Smith, N. L. Histamine Release by Suxamethonium. Anaesthesia.12: 293 (1957).
Thompson, W. L. &Walton, R. P. Evaluation of Plasma Histamine Levels in Dogs Following Administration of Muscle Relaxants, Opiates and Macromolecular Polymers. J. Pharmacol. & Exper. Therap.143: 131 (1964).
Hall, L. W. Unusual Reaction to Suxamethonium Chloride. Brit. Med. J.2: 1305 (1966).
Schoenstadt, D. A. &Whitcher, C. E. Observations on the Mechanism of Succinylcholine-Induced Cardiac Arrhythmias. Anesthesiology.24: 358 (1963).
Takahashi, K. Mechanism of Succinylcholine-Induced Arrhythmia. Jap. J. Anesth.14: 942 (1965).
Kitz, R. J. The Physiology and Pharmacology of Muscle Relaxants. Anesthesia Rounds. (Ayerst Lab.)1: no. 2 (1967).
Johnstone, M. Relaxants and the Human Cardiovascular System. Anaesthesia.10: 122 (1955).
Clinical Anesthesia Conference. Bradycardia after Succinylcholine. New York J. Med.66: 874 (1966).
Leigh, M. D.;McCay, D. D.;Belton, M. K.; &Lewis, G. B. Bradycardia Following Intravenous Administration of Succinylcholine Chloride to Infants and Children. Anesthesiology.18: 698 (1957).
Adams, A. K. &Hall, L. W. An Experimental Study of the Action of Suxamethonium on the Circulatory System. Brit. J. Anaesth.34: 445 (1962).
Auberger, H. Ueber einen Anesthesietodesfall bei einem Kind während der Narkoseeinleitung. Anaesthesist.14: 158 (1965).
Beretervide, K. V. Action of Succinylcholine Chloride on Circulation. Brit. J. Pharmacol.10: 265 (1955).
Gologorski, V. A. &Umanov, I. M. Influence of Listenon on Cardiac Action. Vestn. Khir.7: 102 (1965).
Hoffman, B. F. Autonomic Control of Cardiac Rhythm. Bull. N.Y. Acad. Med.43: 1087 (1967).
Andreucci, S. Succinylcholine: Considerations on a Neurovegetative Effect Following the Injection of Successive Doses. Minerva Anest.28: 385 (1962).
Lupprian, K. G. &Churchill-Davidson, H. C. Effect of Suxamethonium on Cardiac Rhythm. Brit. Med. J.2: 1774 (1960).
Galindo, A. H. &Davis, T. B. Succinylcholine and Cardiac Excitability. Anesthesiology.23: 32 (1962).
Bush, G. H.;Graham, H. A. P.;Littlewood, A. H. M.; &Scott, L. B. Danger of Suxamethonium and Indotracheal Intubation in Anaesthesia for Burns. Brit. Med. J.5312: 1081 (1962).
McCaughey, T. J. Bum Mortality and the Anaesthetist. Canad. Anaesth. Soc. J.10: 501 (1963).
McCaughey, T. J. Hazards of Anaesthesia for the Burned Child. Canad. Anaesth. Soc. J.9: 220 (1962).
Lowenstein, E. Succinylcholine Administration in the Burned Patient. Anesthesiology.27: 494 (1966).
Allan, C. M.;Cullen, W. G.; &Gillies, D. N. M. Ventricular Fibrillation in a Burned Boy. C.M.A.J.85: 432 (1961).
Ieri, R.;Novell, G. P.; &Palumbo, D. So-called Bradycardia Due to Succinylcholine. Minerva Anest.31: 20 (1965).
Bush, G. H. The Use of Muscle Relaxants in Burnt Children. Anaesthesia.19: 231 (1964).
Akdiknen, S. A.;Boba, A.;Landmesser, C. M. Reappraisal of Incidence of Ventricular Arrhythmias Following Succinylcholine Administration. New York State J. Med.65: 2902 (1965).
Evers, W. Reflex Changes in Heart Rate and Rhythm during Laryngeal Manipulation. Thesis, Graduate School, University of Minnesota ( 1954 ).
Kuner, J.;Enescu, V.;Utsu, F.;Boszormenyi, E.;Bernstein, H.; &Corday, E. Cardiac Arrhythmias during Anesthesia. Dis. Chest.52: 580 (1967).
Finer, B. L. &Nylen, B. O. Cardiac Arrest in the Treatment of Burns and Report on Hypnosis as a Substitute for Anesthesia. Plastic and Reconstr. Surg.27: 49 (1961).
Klupp, H.;Kraupp, O.;Honetz, N.;Kobinger, W.; &Loudon, M. Ueber die Freisetzung von Kalium aus der Muskulatur unter Einwirkung einiger Muskelrelaxanten. Arch. Internat. Pharmacodyn.98: 340 (1954).
List, W. F. Serum Potassium Changes during Induction of Anaesthesia. Brit. J. Anaesth.39: 480 (1967).
Stevenson, D. E. Changes in the Blood Electrolytes of Anaesthetized Dogs Caused by Suxamethonium. Brit. J. Anaes.32: 364 (1960).
Sudzhian, A. B. Influence of Depolarizing Relaxants (Ditiline) on Electrolyte Content of Blood Serum in Dogs. Eksp. Khir. Anest.9: 80 (1964).
Holland, W. C.;Klein, R. L.; &Briggs, A. H. Factors Affecting Action of Acetylcholine on Transmembrane Flux of Potassium in Isolated Atria. Am. J. Physiol.196: 478 (1959).
Sliom, C. M. Postoperative Respiratory Inadequacy Following Suxamethonium and Tetrahydroaminoacrine. Anaesthesia.21: 223 (1966).
Surawicz, B. Personal communication.
Paton, W. D. M. Mode of Action of Neuromuscular Blocking Agents. Brit. J. Anaesth.28: 470 (1956).
Wood, E. H.;Collins, D. A.; &Moe, G. K. Potassium Exchanges between Mammalian Muscle and Blood in Relation to Activity. Amer. J. Physiol.126: 657 (1939).
Zaimis, E. J. Transmission and Block of the Motor Endplate and in Autonomic Ganglia. Pharmacol. Rev.6: 53 (1954).
Epstein, B. S.;Rudman, H. L.;Hardy, D. L.; &Downes, H. Comparison of Orotracheal Intubation with Tracheostomy for Anesthesia in Patients with Face and Neck Burns. Anesth. & Anal.45: 352 (1966).
Vassale, M.;Greenspan, K.;Jomain, S.; &Hoffman, B. F. Effects of Potassium on Automaticity and Conduction of Canine Hearts. Am. J. Physiol.207: 334 (1964).
Pick, A. Arrhythmias and Potassium in Man. Am. Heart J.72: 295 (1966).
Maxwell, G. M. Effects of Hyperkalemia upon the General and Coronary Haemodynamics of the Dog. Aust. J. Exper. Biol. Med. Sc.43: 657 (1965).
Chamberlain, M. J. Emergency Treatment of Hyperkalemia. Lancet.1: 464 (1964).
Smith, N. T. The Hemodynamic Effects of Potassium Infusion in Dogs. Anesthesiology.26: 633 (1965).
Surawicz, B. Electrolytes and the ECG. Am. J. Cardiol.12: 656 (1963).
Surawicz, B. Arrhythmias and Electrolyte Disturbances. Bull. New York Acad. Med.43: 1160 (1967).
Surawicz, B. Hemodynamic and Electrocardiographic Effects of Hyperpotassemia: Differences in Response to Slow and Rapid Increases in Concentration of Plasma Potassium. Am. Heart J.73: 647 (1967).
Fisch, C.;Feigenbaum, H.; &Bowers, J. A. The Inhibition of Acetylcholine-Induced Atrioventricular Block by Potassium. J. Clin. Invest.42: 563 (1963).
Fisch, C.;Knoebel, S. B.; &Feigenbaum, H. The Effects of Acetylcholine and Potassium on Repolarization of the Heart. J. Clin. Invest.43: 1769 (1964).
Fisch, C.;Gbeenspan, K.; &Edmunds, R. E. Complete Atrioventricular Block Due to Potassium. Circ. Res.19: 373 (1966).
Greenspan, K.;Wunsch, C. M.; &Fisch, C. Relationship between Potassium and Vagal Action on Atrioventricular Transmission. Circ. Res.17: 39 (1965).
Palazzoadriano, M.;Raineri, A.;Battaglia, A.; &Barone, G. Influenza del potassio sugli effetti elettrocardiografici indotti dalľacetilcolina. Min. Cardioangiologica.13: 581 (1965).
Thomas, E. T. Personal communication.
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Evers, W., B. Racz, G. & Dobkin, A.B. A study of plasma potassium and electrocardiographic changes after a single dose of succinylcholine. Can. Anaes. Soc. J. 16, 273–281 (1969). https://doi.org/10.1007/BF03004455
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DOI: https://doi.org/10.1007/BF03004455