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Succinylcholine

Succinylcholine is a neuromuscular blocking agent used as a skeletal muscle relaxant, particularly in anesthesia and critical care settings.
It acts by depolarizing the motor endplate, leading to an initial muscle fasciculation followed by paralysis.
Succinylcholine has a rapid onset and short duration of action, making it a valuable tool for rapid sequence intubation and other medical procedures requiring immediate muscle relaxation.
The careful monitoring of its use is essential due to the risk of potentially serious adverse effects, such as malignant hyperthermia and hyperkalemia.
Researchers and clinicians must stay up-to-date on the latest protocols, products, and best practices for the safe and effective utilization of succinylcholine in their medical practive.

Most cited protocols related to «Succinylcholine»

Difficult Airway Society Guidelines Update

Cited 37 times

The Difficult Airway Society commissioned a working group to update the guidelines in April 2012. An initial literature search was conducted for the period January 2002 to June 2012 using databases (Medline, PubMed, Embase, and Ovid) and a search engine (Google Scholar). The websites of the American Society of Anesthesiologists (http://www.asahq.org), Australian and New Zealand College of Anaesthetists (http://www.anzca.edu.au), European Society of Anesthesiologists' (http://www.esahq.org/euroanaesthesia), Canadian Anesthesiologists' Society (http://www.cas.ca), and the Scandinavian Society of Anesthesiology and Intensive Care Medicine (http://ssai.info/guidelines/) were also searched for airway guidelines. English language articles and abstract publications were identified using keywords and filters. The search terms were as follows: ‘Aintree intubating catheter’, ‘Airtraq’, ‘airway device’, ‘airway emergency’, ‘airway management’, ‘Ambu aScope’, ‘backward upward rightward pressure’, ‘Bonfils’, ‘Bullard’, ‘bronchoscopy’, ‘BURP manoeuvre’, ‘can't intubate can't ventilate’, ‘can't intubate can't oxygenate’, ‘C-Mac’, ‘Combitube’, ‘cricoid pressure’, ‘cricothyroidotomy’, ‘cricothyrotomy’, ‘C trach’, ‘difficult airway’, ‘difficult intubation’, ‘difficult laryngoscopy’, ‘difficult mask ventilation’, ‘difficult ventilation’, ‘endotracheal intubation’, ‘esophageal intubation’, ‘Eschmann stylet’, ‘failed intubation’, ‘Fastrach’, ‘fiber-optic scope’, ‘fibreoptic intubation’, ‘fiberoptic scope’, ‘fibreoptic stylet’, ‘fibrescope’ ‘Frova catheter', ‘Glidescope’, ‘gum elastic bougie’, ‘hypoxia’, ‘i-gel’, ‘illuminating stylet’, ‘jet ventilation catheter’, ‘laryngeal mask’, ‘laryngeal mask airway Supreme’, ‘laryngoscopy’, ‘lighted stylet’, ‘light wand’, ‘LMA Supreme’, ‘Manujet’, ‘McCoy’, ‘McGrath’, ‘nasotracheal intubation’, ‘obesity’, ‘oesophageal detector device’, ‘oesophageal intubation’, ‘Pentax airway scope’, ‘Pentax AWS’, ‘ProSeal LMA′, ‘Quicktrach’, ‘ramping’, ‘rapid sequence induction’, ‘Ravussin cannula’, ‘Sanders injector’, ‘Shikani stylet’, ‘sugammadex’, ‘supraglottic airway’, ‘suxamethonium’, ‘tracheal introducer’, ‘tracheal intubation’, ‘Trachview’, ‘Tru view’, ‘tube introducer’, ‘Venner APA’, ‘videolaryngoscope’, and ‘videolaryngoscopy’.
The initial search retrieved 16 590 abstracts. The searches (using the same terms) were repeated every 6 months. In total, 23 039 abstracts were retrieved and assessed for relevance by the working group; 971 full-text articles were reviewed. Additional articles were retrieved by cross-referencing the data and hand-searching. Each of the relevant articles was reviewed by at least two members of the working group. In areas where the evidence was insufficient to recommend particular techniques, expert opinion was sought and reviewed.^{8 (link)} This was most notably the situation when reviewing rescue techniques for the ‘can't intubate can't oxygenate’ (CICO) situation.
Opinions of the DAS membership were sought throughout the process. Presentations were given at the 2013 and 2014 DAS Annual Scientific meetings, updates were posted on the DAS website, and members were invited to complete an online survey about which areas of the existing guidelines needed updating. Following the methodology used for the extubation guidelines,^{5 (link)} a draft version of the guidelines was circulated to selected members of DAS and acknowledged international experts for comment. All correspondence was reviewed by the working group.

Frerk C., Mitchell V.S., McNarry A.F., Mendonca C., Bhagrath R., Patel A., O'Sullivan E.P., Woodall N.M, & Ahmad I. (2015). Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. BJA: British Journal of Anaesthesia, 115(6), 827-848.

Publication 2015

Airway Management Anesthesiologist Anesthetist Bronchoscopy Cannula Catheters Dyspnea Emergencies Eructation Esophagus Europeans Frova Hypoxia Intensive Care Intubation Intubation, Intratracheal Laryngoscopy Light Medical Devices Obesity Pharmaceutical Preparations Pressure Rapid Sequence Induction Scandinavians Succinylcholine Sugammadex Trachea Tracheal Extubation

Standardized ECT Dosing Protocol

Cited 9 times

All patients received ECT using a Mecta Spectrum 5000Q (Tualatin, OR). All unilateral treatments utilized the D’Elia placement. As part of routine clinical practice for all twelve psychiatrists in the ECT group during the study period, seizure threshold was determined by dose titration for the first treatment. From 2005 through October 2010, a range of starting doses and titration steps were used at the discretion of the treating psychiatrist. Around this time an informal consensus emerged among treating psychiatrists setting the default starting dose for titrations at 19.2 mC (pulse width 0.3 ms, frequency 20 Hz, amplitude 800 mA, duration 2 s), with subsequent steps of the titration doubling duration according to the MECTA ultrabrief titration tables (step 2: 4s, 38.4 mC; step 3: 8s, 76.8 mC). Subsequent treatments were then targeted at 6× seizure threshold based on the MECTA ultrabrief tables. Generally methohexital was used as the anesthetic agent, but etomidate, propofol, or ketamine were used at the discretion of the treating psychiatrist or anesthesiologist. Succinylcholine was used as the muscle relaxant. Seizure presence and duration were determined based on two lead frontomastoid or bifrontal EEG and by observing motor response using the “cuff method” of inflating a BP cuff on one calf prior to muscle relaxant administration. If a seizure was ongoing at 120 seconds, propofol was given.

Luccarelli J., McCoy TH J.r., Seiner S.J, & Henry M.E. (2021). Total charge required to induce a seizure in a retrospective cohort of patients undergoing dose titration of right unilateral ultrabrief pulse ECT. The journal of ECT, 37(1), 40-45.

Publication 2020

Anesthesiologist Anesthetics Etomidate Ketamine Methohexital Muscle Tissue Neoplasm Metastasis Patients Propofol Psychiatrist Pulse Rate Seizures Succinylcholine Titrimetry

Electroconvulsive Therapy Protocol and Outcomes

Cited 9 times

All patients received ECT using a Mecta Spectrum 5000Q (Tualatin, OR). Seizure threshold was determined by dose titration at the first treatment, with subsequent suprathreshold treatments generally given thrice weekly. Dose, pulse width, and electrode placement were then modified by the treating psychiatrist based on clinical response. Generally, methohexital was used as the anesthetic agent, but etomidate, propofol, or ketamine were used at the discretion of the treating psychiatrist or anesthesiologist. Succinylcholine was used as the muscle relaxant. Seizure presence and duration were determined based on two lead bifrontal or fronto-mastoid EEG and the “cuff method” of inflating a BP cuff on one calf prior to muscle relaxant administration. Diagnosis is the primary clinical diagnosis at the time of first treatment, using ICD-9 codes through 2015 and ICD-10 codes thereafter.

Luccarelli J., McCoy TH J.r., Shannon A.P., Forester B.P., Seiner S.J, & Henry M.E. (2020). Rate of Continuing Acute Course Treatment using Right Unilateral Ultrabrief Pulse Electroconvulsive Therapy At a Large Academic Medical Center. European archives of psychiatry and clinical neuroscience, 271(1), 191-197.

Publication 2020

Anesthesiologist Anesthetics Diagnosis Etomidate Ketamine Methohexital Muscle Tissue Patients Process, Mastoid Propofol Psychiatrist Pulse Rate Seizures Succinylcholine Titrimetry

ECT Dose Titration Retrospective Study

Cited 8 times

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Publication 2020

Anesthetics Diagnosis Ethics Committees, Research Muscle Tissue Patients Process, Mastoid Psychiatrist Pulse Rate Seizures Succinylcholine Titrimetry

Modified Bifrontal ECT for Symptom Remission

Cited 4 times

Patients underwent modified bifrontal ECT, which was the standard at the Anhui Mental Health Center. We used a Thymatron System IV Integrated ECT Instrument (Somatics, Lake Bluff, IL, USA). All the ECT administrations were conducted in the Anhui Mental Health Center. The first three ECT administrations occurred on consecutive days, and the remaining ECT administrations were conducted every other day with a break of weekends until patients' symptoms remitted. If the patient was older than 50 years, the initial percent energy dial setting was to the patient's age (for example, 53% for a 53-year-old patient), and if not, the initial percent energy dial was setted as patient's age minus five (for example, 40% for a 45-year-old patient). If no seizure activity resulted, the percent energy would increase until a therapeutically satisfactory seizure was obtained. During each ECT procedure, patients were under propofol anesthesia. We administered succinylcholine and atropine to relax muscles and suppress the secretion of glands, and monitored seizure activity with electroencephalography.

Wei Q., Tian Y., Yu Y., Zhang F., Hu X., Dong Y., Chen Y., Hu P., Hu X, & Wang K. (2014). Modulation of interhemispheric functional coordination in electroconvulsive therapy for depression. Translational Psychiatry, 4(9), e453-.

Publication 2014

Anesthesia Atropine Diploid Cell Electroencephalography Mental Health Muscle Tissue Patients Propofol secretion Seizures Succinylcholine

Most recents protocols related to «Succinylcholine»

Factors Influencing Malignant Hyperthermia Mortality

Patient demographics included patient age and sex. The frequency of succinylcholine and inhalant anesthetic administration was compared between survivors and deceased MH patients. The first signs suggestive of MH (first MH sign) were also compared in both groups.
The following recorded levels were collected: the frequency of dantrolene administration, timing of dantrolene administration, maximum rate of increase in body temperature, maximum body temperature, highest arterial partial pressure of carbon dioxide (PaCO₂), highest end-tidal carbon dioxide (ETCO₂), lowest arterial blood pH, lowest arterial base excess, highest creatinine kinase, highest serum myoglobin, and highest potassium. The rate of increase in temperature was evaluated over 15-minute intervals. Temperature abnormality was defined as a maximum temperature > 38.8°C or the rate of increase in temperature ≥ 0.5°C/15 min based on CGS and Morio's criteria [9 (link), 10 (link)], respectively. We also compared the dose of dantrolene per body weight, body temperature at the start of dantrolene administration, and interval from the first MH sign to the beginning of dantrolene administration. In addition, the multivariate logistic regression analysis was performed with factors related to time and body temperature: body temperature at the start of dantrolene administration, maximum body temperature, the interval between anesthetic induction to first MH sign, and interval from the first MH sign to the beginning of dantrolene administration as explanatory variables and mortality as the objective variable, since previous reports have shown that maximum body temperature and early dantrolene administration are associated with MH mortality.

Toyota Y., Kondo T., Shorin D., Sumii A., Kido K., Watanabe T., Otsuki S., Kanzaki R., Miyoshi H., Yasuda T., Horikawa Y.T., Mukaida K, & Tsutsumi Y.M. (2023). Rapid Dantrolene Administration with Body Temperature Monitoring Is Associated with Decreased Mortality in Japanese Malignant Hyperthermia Events. BioMed Research International, 2023, 8340209.

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Publication 2023

Anesthetics Arteries Body Temperature Body Weight Carbon dioxide Creatinine Dantrolene High Blood Pressures Inhalation Drug Administration Myoglobin Patients Phosphotransferases Potassium Serum Succinylcholine Survivors

Anesthesia Management for Placental Adhesions

After essential surgical monitoring (noninvasive blood pressure measurement, pulse oximetry, electrocardiography, and capnography), general anesthesia by intravenous bolus injection of propofol (2–2.5 mg/kg) and succinylcholine (1.5–2.0 mg/kg) was induced. After endotracheal intubation, parturients were mechanically ventilated using sevoflurane 2–4 vol% at a tidal volume of 6–8 mL/kg, and an end-tidal carbon dioxide partial pressure was maintained at 35–40 mmHg. Invasive arterial monitoring was routinely conductedand a central venous catheter was inserted if placental adhesions were suspected. Crystalloid solutions (plasma solution or Ringer's lactate solution) or colloid solutions (5% albumin, synthetic colloid (Voluven®; Fresenius Kabi, Bad Homburg, Germany) were administered during anesthesia. Intraoperative hemoglobin (Hb) < 8 g/dL were transfused with packed red blood cells (RBCs). RBCs transfusion units were determined based on the degree of surgical bleeding. As judged by the anesthesiologist, phenylephrine or ephedrine were administered in situations where the mean arterial blood pressure <65 mmHg.

Sim J.H., Cho H.S., Jang D.M., Park H.S., Choi W.J, & Park J.Y. (2023). Effect of intraoperative blood transfusion on inflammatory response in parturients with placenta previa undergoing cesarean section: A prospective observational study. Heliyon, 9(2), e13375.

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Publication 2023

Albumins Anesthesia Anesthesiologist Anesthetics, Intravenous Arteries Capnography Carbon dioxide Colloids Determination, Blood Pressure Electrocardiography Ephedrine Erythrocytes Hemoglobin Intubation, Intratracheal Lactated Ringer's Solution Operative Surgical Procedures Oximetry, Pulse Partial Pressure Phenylephrine Placenta Plasma Propofol Red Blood Cell Transfusion Sevoflurane Solutions, Crystalloid Succinylcholine Tidal Volume Tissue Adhesions Venous Catheter, Central Voluven

Standardized Electroconvulsive Therapy Protocol

Electroconvulsive therapy was performed according to the Dutch treatment guidelines (14 ), using a Thymatron System IV (Somatics Incorporation, Lake Bluff, IL, USA). A constant current (900 mA), brief pulse (0.25–1.0 ms) was used. Electrode position [i.e., right unilateral according to D’Elia (RUL), bifrontotemporal (BL) or left unilateral (LUL)] was chosen by the treating psychiatrist depending on the patients’ clinical condition. The initial dose was determined by titration (i.e., 2.5 seizure threshold in BL and six times seizure threshold in RUL/LUL ECT) or by age-based methods. The standard sedative agent was etomidate (0.2–0.3 mg/kg body mass) and succinylcholine (0.5–1.0 mg/kg body mass) was used as a muscle relaxant.

Verdijk J.P., Schuur G., Pottkämper J.C., ten Doesschate F., Hofmeijer J, & van Waarde J.A. (2023). Medication preventing postictal hypoperfusion and cognitive side-effects in electroconvulsive therapy: A retrospective cohort study. Frontiers in Psychiatry, 14, 1026014.

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Publication 2023

Diploid Cell Etomidate Human Body Muscle Tissue Patients Psychiatrist Pulse Rate Sedatives Seizures Succinylcholine Titrimetry

Enhancing Prehospital Airway Management

The QIP was implemented across the organization in 2018 and 2019. It was led by clinically active paramedics with support from transport medicine physicians, respiratory therapists, and educational specialists. It included the purchase and distribution of new equipment, standardization of equipment and procedures, and provider training in these areas. Table 1 provides a comparison of advanced airway management in the organization before and after implementation of the airway management QIP.Table 1

Advanced airway management in the time periods before and after a quality improvement program

	2016–2017	2020–2021
Annual training	Based on needs analysis No specific focus on advanced airway management	50% focus on advanced airway management Simulation and skill stations
Airway equipment	Direct laryngoscope AirTraq™ video laryngoscope King LT™ LMA™	CMAC™ video laryngoscope with standard geometry and hyper-angulated blades Direct laryngoscope iGel™
Standardization	Variable across the organization	Standardized contents and layout of paramedic response bags Standardized kit dump
Procedures	DFI encouraged Provider’s choice of intubation strategy push dose phenylephrine for hypotension	Checklist mandatory Apneic oxygenation RSI encouraged, Rocuronium for most patients, Succinylcholine also available VL and bougie as standard first attempt Push dose epinephrine and/or phenylephrine for hypotension

von Vopelius-Feldt J., Peddle M., Lockwood J., Mal S., Sawadsky B., Diamond W., Williams T., Baumber B., Van Houwelingen R, & Nolan B. (2023). The effect of a multi-faceted quality improvement program on paramedic intubation success in the critical care transport environment: a before-and-after study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 31, 9.

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Publication 2023

Airway Management Epinephrine Intubation Laryngoscopes Paramedical Personnel Patients Pharmaceutical Preparations Phenylephrine Physicians Respiratory Rate Rocuronium Specialists Succinylcholine

Fluid Therapy for Pediatric Appendicitis

Since children managed for acute abdominal pain due to appendicitis usually have fever, nausea and/or vomiting, and poor fluid intake, we assumed that this group of patients are mildly dehydrated, i.e., <5% loss of body weight upon presentation at our Department of Pediatric Emergency Medicine.^{8 (link)} Therefore, and following our local recommendations for intravenous fluid therapy, all patients were prescribed a balanced crystalloid intravenous infusion at a dose of 50 mL/kg of Ringer’s acetate solution (131 mmol/L sodium, 4 mmol/L potassium, 2 mmol/L magnesium, 110 mmol/L chloride, 30 mmol/L acetate; Fresenius Kabi®) over 4 h. The infusion of this near-isotonic solution was followed by a maintenance fluid and electrolyte therapy phase consisting of a hypotonic 0.46% normal sodium chloride (80 mmol/L sodium, 20 mmol/L potassium, 100 mmol/L chloride in 5% glucose solution) until the start of the surgery. At the maintenance stage, infusion rate was decreased to 80% of normal maintenance fluid therapy. Normal maintenance fluid therapy was calculated according to the following empiric equations: for 0–10 kg = weight (kg) x 100 mL/kg/day, for 10–20 kg = 1000 mL + [weight (kg) x 50 mL/kg/day], and for >20 kg = 1500 mL + [weight (kg) x 20 mL/kg/day].^{9 (link)}All the patients were instructed to take nothing by mouth from admission until surgery.
During surgery, fluids were administered at the anesthetist’s discretion. All patients received intraoperative antibiotic prophylaxis. Anesthesia was induced with alfentanil, propofol, and suxamethonium and maintained with remifentanil and sevoflurane.

Roberts D.N., Vallén P., Cronhjort M., Alfvén T., Sandblom G., Tönroth-Horsefield S., Jensen B.L., Lönnqvist P.A., Frithiof R., Carlström M, & Krmar R.T. (2023). Perioperative water and electrolyte balance and water homeostasis regulation in children with acute surgery. Pediatric Research, 94(4), 1373-1379.

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Publication 2023

Abdomen, Acute Acetate Alfentanil Anesthesia Anesthetist Antibiotic Prophylaxis Appendicitis Child Chlorides Electrolytes Fever Fluid Therapy Glucose Human Body Intravenous Infusion Isotonic Solutions Magnesium Nausea Operative Surgical Procedures Oral Cavity Patients Potassium Propofol Remifentanil Sevoflurane Sodium Sodium Chloride Solutions, Crystalloid Succinylcholine Therapeutics

Top products related to «Succinylcholine»

Model 845 by Harvard Apparatus

The Model 845 is a high-performance syringe pump designed for precise, repeatable fluid delivery in laboratory applications. It features a stepper motor-driven, lead screw-based mechanism that provides accurate control over flow rates, volumes, and infusion/withdrawal sequences. The pump is capable of accommodating a wide range of syringe sizes and can be programmed to deliver fluids at a constant rate or in complex multi-step protocols.

Buprenorphine by Reckitt Benckiser

Sourced in United Kingdom, United States, Germany, Australia, Holy See (Vatican City State), Switzerland

Buprenorphine is a synthetic opioid compound that is used as a laboratory reagent and analytical standard. It is a Schedule III controlled substance in many countries. Buprenorphine is utilized in various research and analytical applications, but its detailed intended use cannot be provided in an unbiased and factual manner without further interpretation.

Succinylcholine by Henry Schein

Succinylcholine is a neuromuscular blocking agent used as a muscle relaxant in medical procedures. It is a short-acting drug that temporarily paralyzes the muscles by blocking the action of acetylcholine at the neuromuscular junction.

Flexivent by SCIREQ

Sourced in Canada

The FlexiVent is a precision lung function testing system developed by SCIREQ. It is designed to measure respiratory mechanics in small laboratory animals, providing researchers with detailed information about lung function. The FlexiVent utilizes forced oscillation techniques to assess parameters such as airway resistance, tissue elastance, and lung volumes. This advanced equipment allows for accurate and reproducible measurements, enabling researchers to gain valuable insights into respiratory physiology and disease models.

29g insulin syringe by BD

Sourced in United States

The 29G insulin syringe is a medical device designed for the subcutaneous injection of insulin. It features a 29-gauge needle and is intended for single use.

29g 29g insulin syringe by BD

The 29G ½ insulin syringe is a medical device designed for the subcutaneous injection of insulin. It features a 29-gauge needle and a ½-inch needle length. The syringe is intended for single use and is made of sterile, disposable materials.

Isoflurane by Harvard Apparatus

Sourced in United States

Isoflurane is a volatile anesthetic agent used for the induction and maintenance of general anesthesia in laboratory animals. It is a colorless, sweet-smelling liquid that is administered through inhalation. Isoflurane provides rapid and reliable anesthesia, with the ability to precisely control the depth of anesthesia.

Isoflurane by Baxter

Sourced in United States, Germany, Sweden, France, Denmark, United Kingdom, Canada, Italy, Norway, Austria, Switzerland, Poland, Puerto Rico, Belgium, Australia, Spain, Finland

Isoflurane is a volatile anesthetic agent used in the medical field. It is a clear, colorless, and nonflammable liquid that is vaporized and administered through inhalation. Isoflurane is primarily used to induce and maintain general anesthesia during surgical procedures.

Homeothermic blanket system by Harvard Apparatus

Sourced in United States, United Kingdom

The Homeothermic blanket system is a lab equipment product designed to maintain a constant temperature for experimental subjects or samples. It consists of a heating blanket and a temperature controller that regulates the blanket's temperature to a user-specified set point.

Spss statistics version 22 by IBM

Sourced in United States, Japan, United Kingdom, Germany, Belgium, Australia, Spain, Switzerland

SPSS Statistics version 22 is a statistical software application developed by IBM. It is designed to analyze and manipulate data, providing users with tools for data management, statistical analysis, and reporting. The software supports a wide range of data types and offers a variety of statistical procedures, enabling users to explore relationships, test hypotheses, and generate insights from their data.

More about "Succinylcholine"

Succinylcholine, also known as suxamethonium, is a powerful neuromuscular blocking agent (NMBA) widely used in anesthesia and critical care settings.
As a skeletal muscle relaxant, it acts by depolarizing the motor endplate, leading to an initial muscle fasciculation followed by rapid and complete paralysis.
Succinylcholine's rapid onset and short duration of action make it a valuable tool for procedures requiring immediate muscle relaxation, such as rapid sequence intubation.
Clinicians must exercise caution when administering succinylcholine due to the risk of potentially serious adverse effects, including malignant hyperthermia and hyperkalemia.
Proper monitoring and adherence to the latest protocols and best practices are essential for the safe and effective use of this medication.
Researchers and clinicians can explore the latest succinylcholine research using AI-driven comparison platforms like PubCompare.ai.
These tools can help identify optimal protocols, products, and solutions from the literature, preprints, and patents, supporting data-driven decision making.
When used in conjunction with other anesthetic agents like buprenorphine, isoflurane, and homeothermic blanket systems, succinylcholine can be an integral part of a comprehensive anesthetic regimen.
The use of specialized equipment, such as the FlexiVent system and 29G insulin syringes, may also be relevant in administering and monitoring the effects of succinylcholine.
By staying up-to-date on the latest research and best practices, clinicians can ensure the safe and effective utilization of succinylcholine in their medical practice, leading to improved patient outcomes.