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Canadian Journal of Anesthesia, Vol 17, 477-484, Copyright © 1970 by Canadian Anesthesiologists' Society

Prevention of Succinylcholine-Induced Hyperkalaemia By Magnesium Sulfate

J. ANTONIO ALDRETE M.D.1, ANDRES ZAHLER M.D., and JERRY K. AIKAWA M.D.

1 Department of Anesthesiology, University of Miami School of Medicine, Miami, Florida

By the previous intravenous administration of 1 gm of magnesium sulfate, the muscle fasciculations produced by succinylcholine were prevented in 18 (30 per cent) and ameliorated in 24 (40 per cent) of a group of 60 patients induced with sodium thiopental. Serum calcium, magnesium, and potassium concentrations were determined before and five minutes after injection of the drugs. Patients receiving MgSO4 (1 or 2 gm) had increases in Mg++ and reduction of Ca++ and K+ even when muscle fasciculations were evident. Thiopental and succinylcholine administration produced slight diminutions of serum Mg++ and Ca++ and rises of K+. When d-tubocurarine was substituted for MgSO4 in the sequence of injections, muscle fasciculations were hindered, K+ values decreased slightly, and Ca++ and Mg++ levels were barely altered.

It is inferred that the rise of Mg++ concentration in serum resulting after the injection of MgSO4 might impede muscle end-plate depolarization by decreasing the amount of acetylcholine quanta released by the nerve ending, and/or by sensitizing the same receptor site.

Note:

From the Divisions of Anaesthesiology and Laboratory Medicine, University of Colorado Medical Center and Veterans Administration Hospital, Denver, Colorado.






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Copyright © 1970 by the Canadian Anesthesiologists' Society.