Anesthesiology pp 143-147 | Cite as

Depolarizing Neuromuscular Blocking Agents

  • Caroline S. GrossEmail author
  • Zhiling Xiong


Succinylcholine was first introduced into clinical practice in the 1950s, and is currently the only depolarizing neuromuscular blocker in use. It is unique among the drugs used for muscle relaxation in its rapid onset and short duration of action. These characteristics account for its extensive use in scenarios requiring emergency control of the airway. However, succinylcholine has the potential to cause significant adverse effects, and rapid acting nondepolarizing agents offer an alternative for rapid tracheal intubation. Despite its side effect profile, succinylcholine is still widely used in clinical practice.


Succinylcholine Pseudocholinesterase deficiency Phase II blockade Dibucaine number Malignant hyperthermia 


  1. 1.
    Jonsson M, Dabrowski M, Gurley DA, et al. Activation and inhibition of human muscular and neuronal nicotinic acetylcholine receptors by succinylcholine. Anesthesiology. 2006;104:724–33.CrossRefPubMedGoogle Scholar
  2. 2.
    Donati D. Neuromuscular blocking agents. In: Barash et al., editors. Clinical anesthesia. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 523–57.Google Scholar
  3. 3.
    Miller RD. Neuromuscular blocking drugs. In: Basics of anesthesia. 6th ed. Philadelphia: Elsevier Saunders; 2011. p. 143–61.Google Scholar
  4. 4.
    Naguib M, Samarkandi AH, El-Din ME, Abdullah K, Khaled M, Alharby SW. The dose of succinylcholine required for excellent endotracheal intubating conditions. Anesth Analg. 2006;102:151–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Lemmens HJ, Brodsky JB. The dose of succinylcholine in morbid obesity. Anesth Analg. 2006;102:438–42.CrossRefPubMedGoogle Scholar
  6. 6.
    Thapa S, Brull SJ. Succinylcholine-induced hyperkalemia in patients with renal failure: an old question revisited. Anesth Analg. 2000;91:237–41.PubMedGoogle Scholar
  7. 7.
    Perry JJ, Lee JS, Sillberg V, Wells GA. Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database Syst Rev. 2008;. doi: 10.1002/14651858.CD002788.pub2.Google Scholar
  8. 8.
    Gronert GA. Cardiac arrest after succinylcholine: mortality greater with rhabdomyolysis than receptor upregulation. Anesthesiology. 2001;94:523–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Schreiber JU, Lysakowski C, Fuchs-Buder T, et al. Prevention of succinylcholine-induced fasciculation and myalgia: a meta-analysis of randomized trials. Anesthesiology. 2005;103:877–84.CrossRefPubMedGoogle Scholar
  10. 10.
    Naguib M, Lien CA, Claude M. Pharmacology of neuromuscular blocking drugs. In: Miller RD, editor. Miller’s anesthesia. 8th ed. Philadelphia: Elsevier Saunders; 2015. p. 958–91.Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Anesthesiology, Perioperative and Pain MedicineBrigham and Women’s HospitalBostonUSA

Personalised recommendations