#suxamethonium

[oaresearchpaper]

Malignant hyperthermia (MH) is a pharmacogenetic disorder and life-threatening syndrome of skeletal muscle with exposure to potent inhalational anesthetics (Halothane, desflurane) and depolarizing muscle relaxant (succinylcholine). To determine the incidence of anesthetic drug induced malignant hyperthermia in patients in lady reading hospital Peshawar. This cross-sectional study was carried out in duration of six months (February to August 2019) in lady reading hospital (LRH) Peshawar. The intension of this study was to determine the incidence of drug induced (MH) in patients who are going for surgical procedure under general anaesthesia especially exposure to inhalational agents and Suxamethonium. Ethical approval was taken from ethical committee of Khyber Medical University (KMU) and Leady Reading Hospital (LRH) Peshawar. Informed consent was taken from Participants. Demographics details and patient’s data were recorded and analysed through SPSS. Data of 424 patients were obtained in which males were 268 (63.2%) and female were 156 (36.8%). The mean age of the patients was 31.2±19.4. There was no case of malignant hyperthermia among these patients. The pinpoint incidence of malignant hyperthermia is unknown. In our study we are not find any case of malignant hyperthermia.

[stemlyns]

JC: Rocuronium or Suxamethoniun for RSI. St Emlyn's

JC: Rocuronium or Suxamethoniun for RSI. Equivalence, non-inferiority or difference???? #journalclub #airway #RSI #foamed #roc #sux

We’re always a little cautious (scared) about entering any sort of emergency airway debate on social media as opinions are usually strongly held, and evidence is often of the lighter variety. One of the more controversial questions is in the use of first choice paralytics for ED RSI. In the past we used suxamethonium for its rapid action, but it does have rather a lot of side effects which have…

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[medinuggets-blog]

TOP 2 Drugs for ED Sedation / Intubation

From 6 down to 2!

A take on the only 2 drugs you need in your pocket......

·      Great analgesic properties

·      Haemodynamically stable – sympathomimetic (increase HR / BP)

·      Preserve airway reflexes

·      Bronchodilator (useful in asthmatics)

·      Can cause brief apnoea but no hypoventilation

·      Safe in head injuries

·      Dose:

o   Intubation - 1-2mg/kg IV or 2-4mg/kg IM

o   Sedation - Start at 1mg/kg IV or 4mg IM

·      Watch out for hyper-salivation (give atropine – can cause laryngospasm)

·      10% will get emergence phenomenon (vivid dreams etc.); reportedly much less commonly negative / ‘trippy’ phenomenon in children

  2. Suxamethonium

·      Depolarising muscle relaxant

·      Rapid onset – intubation conditions 60-90 secs

·      Causes fasciculation

·      Offset - 8-9 minutes

·      Broken down in plasma (doesn’t require renal / hepatic metabolism)

·      Contraindications:

o   Hyperkalaemia OR likely to be (eg. tissue injury ++ such as burns)

o   Neuromuscular disorders (including

·      Dose (intubation only)

o   1-2mg/kg

  Disclaimer: The above information is meant as a GUIDE ONLY. Information is directed at  experienced clinicians working in ED/Anaesthetics/Critical care. Doses are meant as a guide ONLY. These drugs should ONLY be provided by experienced clinicians in an appropriately monitored environment AFTER consultation with an appropriate pharmacopeia.

#FOAMed