Most adverse reactions to succinylcholine are extensions of pharmacologic effects
CV: arrhythmias, bradycardia, hypotension.
F and E: HYPERKALEMIA.
MS: RHABDOMYOLYSIS, muscle fasciculation, myoglobinemia (↑ in children), myoglobinuria (↑ in children).
Resp: APNEA, bronchospasm.
Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), MALIGNANT HYPERTHERMIA, tachyphylaxis.
IV route is preferred, but deep IM injection may be used in children and patients without vascular access
Test Dose
- IV (Adults): 5–10 mg (0.1 mg/kg), then assess respiratory function.
Short Procedures
- IV (Adults): 0.6 mg/kg (range 0.3–1.1 mg/kg) up to 150 mg total dose; additional doses depend on response, maintenance: 0.04–0.07 mg/kg every 5–10 min as needed.
- IV (Children): 1–2 mg/kg, up to 150 mg; additional doses depend on response, maintenance: 0.3–0.6 mg/kg every 5–10 min as needed, (continuous infusion not recommended in children or neonates because of the risk of malignant hyperthermia).
Prolonged Procedures
- IV (Adults): 2.5 mg/min infusion (range 0.5–10 mg/min).
Intramuscular Dosing
- IM (Adults and Children): Up to 3 — 4 mg/kg (total dose not to exceed 150 mg).
Therapeutic Classification: neuromuscular blocking agents-depolarizing
Absorption: Well absorbed after deep IM administration.
Distribution: Widely distributed into extracellular fluid. Crosses the placenta in small amounts.
Metabolism/Excretion: 90% metabolized by pseudocholinesterase in plasma. 10% excreted unchanged by the kidneys.
Half-life: Unknown.
(skeletal muscle paralysis)