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Vermeidung succinylcholinbedingter Zwischenfälle

  • Conference paper
Konzepte zur Sicherheit in der Anästhesie

Part of the book series: Klinische Anästhesiologie und Intensivtherapie ((KAI,volume 42))

  • 19 Accesses

Zusammenfassung

Das depolarisierende Muskelrelaxans Succinylcholin (SCH) besteht aus 2 Acetylcholinmolekülen. In Konkurrenz mit der physiologischen Überträgersubstanz besetzt es die cholinergen Rezeptoren der neuromuskulären Endplatte [26]. Nach anfänglicher Erregung der Muskelfaser unterbricht es die Impuls-übertragung vom Nerv auf die Muskelzelle und führt zur neuromuskulären Blockade (NMB; [121]). Diese ist quantifizierbar anhand der Reaktion ausgewählter Muskeln auf indirekte Reizung mit dem Nervenstimulator [117]. Die Wirkdauer wird wesentlich bestimmt durch die pseudocholinesteraseabhängige Hydrolyse von SCH [70]. Im Regelfall, d.h. bei intakter Enzymfunktion, führt die intravenöse Injektion von 1 mg/kg KG zur 100 %igen NMB mit kurzer Anschlagzeit (<1 min) und Wirkdauer (10–12 min; [19, 37, 95]. Neben diesem erwünschten Effekt lassen sich mit unterschiedlicher Häufigkeit unerwünschte Effekte beobachten [87]. Sie betreffen nicht nur die Skelettmuskulatur, sondern auch weitere Organe. Teilweise stehen sie im Zusammenhang mit den pharmakologischen Eigenarten von SCH (Tabelle 1), teilweise sind sie allgemeiner Natur (z.B. Anaphylaxie). Im klinischen Kontext können sie sich ausweiten zu Komplikationen und lebensbedrohlichen Zwischenfällen. Im folgenden wird die Frage von deren Vermeidbarkeit behandelt.

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  1. J. Plötz
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  1. Institut für Anaesthesiologie, Universität Erlangen-Nürnberg, Krankenhausstr. 12, D-W-8520, Erlangen, Germany

    E. Rügheimer Prof. Dr. med.

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Plötz, J. (1993). Vermeidung succinylcholinbedingter Zwischenfälle. In: Rügheimer, E. (eds) Konzepte zur Sicherheit in der Anästhesie. Klinische Anästhesiologie und Intensivtherapie, vol 42. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77781-3_12

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  • DOI: https://doi.org/10.1007/978-3-642-77781-3_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-55931-3

  • Online ISBN: 978-3-642-77781-3

  • eBook Packages: Springer Book Archive

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