Succinylcholine

(Anectine)

 

INDICATIONS:

  • Skeletal muscle relaxation during operative and manipulative procedures
  • Facilitate management of patients undergoing mechanical ventilation
  • Adjunct to general anesthesia

 

ADMINISTRATION:

  • IV, IO

 

DOSAGE:

ADULT:

  • 1.5mg/kg over 30 seconds; not to exceed 150mg total dose

 

PEDIATRIC:

  • NOT INDICATED.

 

THERAPEUTIC EFFECTS:

  • Prevents neuromuscular transmission by blocking the effect of acetylcholine at the myoneural junction

 

RELATIVE CONTRAINDICATIONS:

  • Hypersensitivity to succinylcholine
  • History of malignant hyperthermia
  • Skeletal muscle myopathies
  • Penetrating eye injury

 

SIDE EFFECTS:

  • Apnea
  • Cardiac arrhythmias
  • Increased intraocular pressure
  • Muscle fasciculations
  • RS

REVISED FORMULARY 2010 Page 78

 

SPECIAL NOTES / RESTRICTIONS:

  • Succinylcholine has no effect on consciousness, pain threshold, or cerebration. Must be used only with adequate sedation.
  • In elderly time of onset may be delayed due to slower circulation time in cardiovascular disease.
  • Use with extreme caution in patients with severe burns, electrolyte imbalance, hyperkalemia, and those receiving quinidine or digitalis.
  • The potential for releasing histamine is present following succinylcholine use. Serious histamine-mediated flushing, hypotension, and bronchoconstriction are, however, uncommon in clinical usage.
  • Incidence of side effects increase with second or subsequent doses.
  • STORAGE: Refrigerate at 35 O - 46 O F. Multi-dose vials are stable for up to 14 days at room temperature.
  • RSI MAY BE initiated by Standing Order or Protocol. It is RECOMMENDED – where feasible – that On-Line Medical Control be obtained prior to initiation– but this should not supercede the appropriate care of the patient.
  • 100% QI / PI is required for ALL RSI runs.