SUCCINYLCHOLINE CHLORIDE

It is a depo-larising short acting neuromuscular blocking agent for intravenous administration.

Indications

Tracheal intubation, short operations, orthopaedic, manipulation, electroconvulsive therapy and closure of the peritoneum. Prolonged musular relaxation in surgery can be attained by means of repeated injections of the drug by continuous intravenous drip.

Dosage

20 mg (0.4 ml) to 100 mg (2 ml). Intubation: 50 mg (1 ml) to 80 mg (1.6 ml) Electroconvulsive therapy : 40 mg (0.8 ml) to 75 mg (1.5 ml) Manipulation : 80 mg (1.6 ml) For administration by continuous i.v. drip, a 0.1% soln may be prepared by mixing 10 ml injection of succinylcholine chloride with 500 ml of 5% glucose or isotonic sodium chloride. The adult dose ranges from 2 to 5 mg per minute.

Contra-Indications

Patients known to have a typical serum pseudocholinesterase or low serum levels of pseudo-cholinesterase. Myasthenia gravis. Myasthenic syndrome, hyperkalaemia. Glaucoma. Ophthalmic cases when the anterior chamber of the eye is open. Premature infants and new born babies.

Special Precautions

Severe burns, pregnancy. It should not be administered until the anaesthetic has taken full effect. Hepatic or renal failure. Paediatrics: Use with caution in age under 8 year and the male sex. Pregnancy: Use if clearly indicated. Lactaion: Use with caution. Elderly: No absolute contraindication.

Side Effects

Muscle pain, Malignant hyperpyrexia, Myoglobinuria, hypersensitivity, fever, bronchospasm transient rise in intra-ocular pressure and salivary gland enlargement.

Drug Interactions

Neuromuscular blocking action potentiated by promazine, oxytocin, quinidine, beta blockers, lignocaine, procainamide, lithium magnesium salts, chloroquin, isoflurane. Insecticides, antineoplastic antimalarial drugs may result in low level of pseudocholinesterase.