Depolarisierende Muskelrelaxanzien — Vorteile, Nachteile, Nebenwirkungen

Conference paper


Anfang der 50er Jahre wurden Decamethonium, Hexacarbacholin und Succinylcholin als depolarisierende Relaxanzien in die Klinik eingeführt. Heute hat von diesen drei Substanzen nur noch Succinylcholin praktische Bedeutung.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abdul-Rasool IH, Sears DH, Katz RL (1987) The effect of a second dose of succi- nylcholine on cardiac rate and rhythm following induction of anesthesia with etomidate or midazolam. Anesthesiology 67: 795–797PubMedCrossRefGoogle Scholar
  2. 2.
    Baraka A (1988) Severe bradycardia following propofol-suxamethonium sequence. Br J Anaesth 61: 482–483PubMedCrossRefGoogle Scholar
  3. 3.
    Barr AM, Thornley BA (1976) Thiopentone and suxamethonium crash induction. Anaesthesia 31: 23–29PubMedCrossRefGoogle Scholar
  4. 4.
    Baur H, Kohlschütter B, Roth F (1976) Hyperkaliämie nach Succinylcholin bei septischen Patienten der Abdominalchirurgie. Anaesthesist 25: 6–9PubMedGoogle Scholar
  5. 5.
    Brandt L, Henneberg U (1981) Verhindert die Präkurarisierung den succinylcholinbeding- ten Serumkaliumanstieg bei Risikopatienten? Anästh Intensivther Notfallmed 16: 353- 355PubMedCrossRefGoogle Scholar
  6. 6.
    Brennan HJ (1956) Dual action of suxamethonium chloride. Br J Anaesth 28: 159–168PubMedCrossRefGoogle Scholar
  7. 7.
    Caldwell JE, Heier T, Kitts JB, Lynam DP, Fahey MR, Miller RD (1989) Comparison of the neuromuscular block induced by mivacurium, suxamethonium or atracurium during nitrous oxide-fentanyl anaesthesia. Br J Anaesth 63: 393–399PubMedCrossRefGoogle Scholar
  8. 8.
    Carnie J (1982) Continuous suxamethonium infusion for microlaryngeal surgery. Br J Anaesth 54: 11–14PubMedCrossRefGoogle Scholar
  9. 9.
    Chestnut RJ, Healey TEJ, Harper NJN, Faragher EB (1989) Suxamethonium — the relation between dose and response. Anaesthesia 44: 14–18PubMedCrossRefGoogle Scholar
  10. 10.
    Cicala RC, Westbrook L (1988) An alternative method of paralysis for rapid-sequence induction. Anesthesiology 69: 983–986PubMedCrossRefGoogle Scholar
  11. 11.
    Crul JF (1985) Klinische Pharmakokinetik von Succinylcholin. In: Agoston S, Bergmann H, Schwarz S, Steinbereithner K (Hrsg) Muskelrelaxanzien — Therapeutische Grenzen. Verlag Wilhelm Maudrich, Wien München Bern, 91–97Google Scholar
  12. 12.
    Crul JF, Long GJ, Brunner EA, Coolen JMW (1966) The changing pattern of neuromuscular blockade caused by succinylcholine in man. Anesthesiology 27: 729–735PubMedCrossRefGoogle Scholar
  13. 13.
    Cullen PM, Turtle M, Prys-Roberts C, Way WL, Dye J (1987) Effect of propofol anesthesia on baroreflex activity in humans. Anesth Analg 66: 1115–1120PubMedGoogle Scholar
  14. 14.
    Elia ST, Lebowitz PW (1988) Succinylcholine-induced idioventricular rhythm. Anesth Analg 67: 588–589PubMedCrossRefGoogle Scholar
  15. 15.
    Erkola O (1990) Effects of precurarisation on suxamethonium-induced postoperative myalgia during the first trimester of pregnancy. Acta Anaesthesiol Scand 34: 63–67PubMedCrossRefGoogle Scholar
  16. 16.
    Erkola O, Salmenperä A, Kuoppamäki R (1983) Five non-depolarizing muscle relaxants in precurarization. Acta Anaesthesiol Scand 27: 427–432PubMedCrossRefGoogle Scholar
  17. 17.
    Fisher M, Munro I (1983) Life-threatening anaphylactoid reactions to muscle relaxants. Anesth Analg 62: 559–564PubMedCrossRefGoogle Scholar
  18. 18.
    Flewellen EH, Nelson TE (1984) Halothane-succinylcholine induced masseter spasm: indicative of malignant hyperthermia susceptibility? Anesth Analg 63: 693–697PubMedCrossRefGoogle Scholar
  19. 19.
    Forstmann V, Schuh FT (1988) Wirkungseintritt und Intubationsbedingungen nach Atracurium, Vecuronium und Suxamethonium. Anaesthesist 37: 311–315PubMedGoogle Scholar
  20. 20.
    Futter ME, Donati F, Bevan DR (1983) Prolonged suxamethonium infusion during nitrous oxide anaesthesia supplemented with halothane or fentanyl. Br J Anaesth 55: 947–953PubMedCrossRefGoogle Scholar
  21. 21.
    Gronert GA, Dotin LN, Ritchey CR, Mason AD (1969) Succinylcholine-induced hyperkalemia in burned patients — IL Anesth Analg 48: 958–962Google Scholar
  22. 22.
    Guillermo FP, Pretel CMM, Royo FT, Macias MJP, Ossorio RA, Gomez JAA, Vidal CJ (1988) Prolonged suxamethonium-induced neuromuscular blockade associated with or- ganophosphate poisonning. Br J Anaesth 61: 233–236CrossRefGoogle Scholar
  23. 23.
    Harle DG, Baldo BA, Fisher MM (1984) Detection of IgE antibodies to suxamethonium after anaphylactoid reactions during anaesthesia. The Lancet: 930–932Google Scholar
  24. 24.
    Hartman GS, Fiamengo SA, Riker WF (1986) Succinylcholine: mechanism of fascicula- tions and their prevention by d-tubocurarine or diphenylhydantoin. Anesthesiology 65: 405–413PubMedCrossRefGoogle Scholar
  25. 25.
    Hawkins JL, Johnson TD, Kubicek MA, Skjonsby BS, Morrow DH, Joyce TH (1990) Vecuronium for rapid-sequence intubation for cesarean section. Anesth Analg 71: 185- 190PubMedCrossRefGoogle Scholar
  26. 26.
    Henderson WAV (1984) Succinylcholine-induced cardiac arrest in unsuspected Duchenne muscular dystrophy. Can Anaesth Soc J 31: 444–446PubMedCrossRefGoogle Scholar
  27. 27.
    Hilgenberg JC, Stoelting RK (1981) Characteristics of succinylcholine-produced phase II neuromuscular block during enflurane, halothane, and fentanyl anesthesia. Anesth Analg 60: 192–196PubMedGoogle Scholar
  28. 28.
    Horrow JC, Lambert DH (1984) The search for an optimal interval between pretreatment dose of d-tubocurarine and succinylcholine. Can Anaesth Soc J 5: 528–533CrossRefGoogle Scholar
  29. 29.
    Horton WA, Fergusson NN (1988) Hyperkalaemia and cardiac arrest after the use of suxamethonium in intensive care. Anaesthesia 43: 890–891PubMedCrossRefGoogle Scholar
  30. 30.
    Katz RL (1973) Electromyographic and mechanical effects of suxamethonium and tubo- curarine on twitch, tetanic and posttetanic responses. Br J Anaesth 45: 849–859PubMedCrossRefGoogle Scholar
  31. 31.
    Katz RL, Ryan JF (1969) The neuromuscular effects of suxamethonium in man. Br J Anaesth 41: 381–390PubMedCrossRefGoogle Scholar
  32. 32.
    Khan TZ, Khan RM (1983) Changes in serum potassium following succinylcholine in patients with infections. Anesth Analg 62: 327–331PubMedCrossRefGoogle Scholar
  33. 33.
    Kunjappan VE, Brown EM, Alexander GD (1986) Rapid sequence induction using vecuronium. Anesth Analg 65: 503–506PubMedCrossRefGoogle Scholar
  34. 34.
    Laurence AS (1987) Myalgia and biochemical changes following intermittent suxamethonium administration. Anaesthesia 42: 503–510PubMedCrossRefGoogle Scholar
  35. 35.
    Lee C (1975) Dose relationships of phase II, tachyphylaxis and train-of-four fade in suxamethonium-induced dual neuromuscular block in man. Br J Anaesth 47: 841–845PubMedCrossRefGoogle Scholar
  36. 36.
    Lee C (1976) Self-antagonism: a possible mechanism of tachyphylaxis in suxamethonium-induced neuromuscular block in man. Br J Anaesth 48: 1097–1101PubMedCrossRefGoogle Scholar
  37. 37.
    Lee C, Chen D, Nagel EL, Katz RL (1976) Spontaneous recovery of the thumb twitch from neuromuscular block by suxamethonium in anaesthetized man. Br J Anaesth 48: 91–95PubMedCrossRefGoogle Scholar
  38. 38.
    Lee SC, Abe T, Sato T (1987) Rhabdomyolysis and acute renal failure following use of succinylcholine and enflurane: report of a case. J Oral Maxillofac Surg 45: 789–792PubMedCrossRefGoogle Scholar
  39. 39.
    Leyser KH, Konietzke D, Hennes JJ (1989) Vecuroniumbromid- und Succinylcholinver- fahren zur mittellangen Relaxation. Anaesthesist 38: 288–293PubMedGoogle Scholar
  40. 40.
    Lindgren L, Klemola UM, Saarnivaara L (1988) Optimal time interval between pretreatment with alcuronium and suxamethonium during anaesthetic induction. Acta Anaesthesiol Scand 32: 244–247PubMedCrossRefGoogle Scholar
  41. 41.
    Magee DA, Robinson RJS (1987) Effect of stretch exercises on suxamethonium induced fasciculations and myalgia. Br J Anaesth 59: 596–601PubMedCrossRefGoogle Scholar
  42. 42.
    Martin C, Bonneru JJ, Brun JP, Albanese J, Gouin F (1987) Vecuronium or suxamethonium for rapid sequence intubation: which is better? Br J Anaesth 59: 1240–1244PubMedCrossRefGoogle Scholar
  43. 43.
    Mathias J (1970) The role of the non depolarizing drugs in the prevention of suxamethonium bradykardia. Br J Anaesth 42: 609PubMedCrossRefGoogle Scholar
  44. 44.
    Melnick B, Chalasani J, Uy NTL, Phitayakorn P, Mallett SV, Rudy TE (1987) Decreasing post-succinylcholine myalgia in outpatients. Can J Anaesth 34: 238–241PubMedCrossRefGoogle Scholar
  45. 45.
    Mötsch J, Fuchs W, Hoch P, Kaas V, Hutschenreuter K (1987) Side effects and changes in pulmonary function after fixed dose precurarization with alcuronium, pancuronium or vecuronium. Br J Anaesth 59: 1528–1532PubMedCrossRefGoogle Scholar
  46. 46.
    Naguib M, Farag H, Magbagbeola JAO (1987) Effect of pretreatment with lysine acetyl salicylate on suxamethonium-induced myalgia. Br J Anaesth 59: 606–610PubMedCrossRefGoogle Scholar
  47. 47.
    Nelson TE, Flewellen EH (1983) The malignant hyperthermia syndrome. New Engl J Med 7: 416–418CrossRefGoogle Scholar
  48. 48.
    O’Sullivan EP, Williams NE, Calvey TN (1988) Differential effects of neuromuscular blocking agents on suxamethonium-induced fasciculations and myalgia. Br J Anaesth 60: 367–371PubMedCrossRefGoogle Scholar
  49. 49.
    Oerding H (1985) Incidence of malignant hyperthermia in Denmark. Anesth Analg 64: 700–704Google Scholar
  50. 50.
    Oshita S, Tamura H, Masuda T, Fukuda S, Takeshita H (1987) Alcuronium pretreatment attenuates succinylcholine-induced increases in plasma catecholamine concentrations in humans. Anesth Analg 66: 314–316PubMedCrossRefGoogle Scholar
  51. 51.
    Oxorn DC, Whatley GS, Knox JWD, Hooper JGV (1990) Atracurium and d-tubocurarine pretreatment in the prevention of succinylcholine myalgias: a study in vaginal hysterectomies. Can J Anaesth 37: S140Google Scholar
  52. 52.
    Powell DR, Miller R (1975) The effect of repeated doses of succinylcholine on serum potassium in patients with renal failure. Anesth Analg 54: 746–748PubMedCrossRefGoogle Scholar
  53. 53.
    Ramsey FM, Lebowitz PW, Savarese JJ, Ali HH (1980) Clinical characteristics of long- term succinylcholine neuromuscular blockade during balanced anesthesia. Anesth Analg 59: 110–116PubMedGoogle Scholar
  54. 54.
    Redan JA, Livingston DH, Tortella BJ, Rush BF (1991) The value of intubating and paralyzing patients with suspected head injury in the emergency department. The Journal of Trauma 31: 371–375PubMedCrossRefGoogle Scholar
  55. 55.
    Schoenstadt DA, Whitcher CE (1963) Observations on the mechanism of succinyldi- choline-induced cardiac arrhythmias. Anesthesiology 24: 358–362PubMedCrossRefGoogle Scholar
  56. 56.
    Sears DH, Abdul-Rasool IH, Katz RL (1988) The effect of a second dose of succinylcholine on cardiac rate and rhythm following induction of anesthesia with ketamine. Anesthesiology 68: 644PubMedCrossRefGoogle Scholar
  57. 57.
    Sinclair G (1990) Masseter spasm following suxamethonium. British Journal of Hospital Medicine 45: 342Google Scholar
  58. 58.
    Sosis M, Broad T, Larijani GE, Marr AT (1987) Comparison of atracurium and d-tubocurarine for prevention of succinylcholine myalgia. Anesth Analg 66: 657–659PubMedGoogle Scholar
  59. 59.
    Swartz CM (1990) Electroconvulsive therapy emergence agitation and succinylcholine dose. The Journal of Nervous and Mental Disease 178: 455–457PubMedCrossRefGoogle Scholar
  60. 60.
    Tammisto T (1985) Muskelfaszikulationen, Freisetzung von Muskelbestandteilen und Muskelschmerzen nach Anwendung depolarisierender Muskelrelaxanzien. In: Agoston S, Bergmann H, Schwarz S, Steinbereithner K (Hrsg) Muskelrelaxanzien — Therapeutische Grenzen. Verlag Wilhelm Maudrich, Wien München Bern, 98–106Google Scholar
  61. 61.
    Trepanier CA, Brousseau C, Lacerte L (1988) Myalgia in outpatient surgery: comparison of atracurium and succinylcholine. Can J Anaesth 35: 255–259PubMedCrossRefGoogle Scholar
  62. 62.
    Van Aken H, Scherer R, Lawin P (1980) Anästhesie und intraokulärer Druck. Anästh Intensivther Notfallmed 15: 293–302PubMedCrossRefGoogle Scholar
  63. 63.
    Verner L (1983) K+-Spiegel nach Succinylcholingabe während abklingender Wirkung von nichtdepolarisierenden Muskelrelaxanzien. Dissertation, Medizinische Hochschule Hannover, 1–37Google Scholar
  64. 64.
    Wald-Oboussier G, Lohmann Ch, Viell B, Doehn M (1987) „Self-taming“: Eine Alternative zur Prophylaxe des durch Succinylcholin induzierten Schmerzes. Anaesthesist 36: 426–430PubMedGoogle Scholar
  65. 65.
    Whithington DE, Leung KBP, Bromley L, Scadding GK, Pearce FL (1987) Basophil histamine release. Anaesthesia 42: 850–854CrossRefGoogle Scholar
  66. 66.
    Whittaker M, Vickers MD (1970) Initial experiences with the Cholinesterase research unit. Br J Anaesth 42: 1016–1020PubMedCrossRefGoogle Scholar
  67. 67.
    Yentis SM (1990) Suxamethonium and hyperkalaemia. Anaesth Intensive Care 18: 92–101PubMedGoogle Scholar
  68. 68.
    Youngman PR, Taylor KM, Wilson JD (1983) Anaphylactoid reactions to neuromuscular blocking agents: a commonly undiagnosed condition? The Lancet: 597–599Google Scholar

Copyright information

© Dr. Dietrich Steinkopff Verlag GmbH & Co. KG 1994

Authors and Affiliations

  • I. Frey
    • 1
    • 2
  1. 1.Medizinische Hochschule HannoverDeutschland
  2. 2.Lehrstuhl für AnaesthesiologieUniversitätsklinikumRegensburgDeutschland

Personalised recommendations