A 55-year-old man on ICU requires rapid sequence induction for emergency intubation. He weighs 100 kg. Suxamethonium is chosen for neuromuscular block...

Question

A 55-year-old man on ICU requires rapid sequence induction for emergency intubation. He weighs 100 kg. Suxamethonium is chosen for neuromuscular blockade. His serum potassium is 5.0 mmol/L. He sustained a spinal cord injury 10 days ago. Why is suxamethonium contraindicated in this patient?

Accepted Answer

Denervation injury (spinal cord injury >48-72 hours old) causes upregulation of extrajunctional acetylcholine receptors, and suxamethonium-induced depolarisation of these receptors causes massive efflux of potassium, risking fatal hyperkalaemia

Answer

Suxamethonium causes malignant hyperthermia in spinal cord injury

Answer

Suxamethonium has no effect after spinal cord injury

Answer

Suxamethonium causes prolonged paralysis in spinal cord injury

Answer

Suxamethonium interacts with methylprednisolone given for spinal injury

uk-fficm MCQ (SBA): Suxamethonium - Hyperkalaemia Risk

A 55-year-old man on ICU requires rapid sequence induction for emergency intubation. He weighs 100 kg. Suxamethonium is chosen for neuromuscular blockade. His serum potassium is 5.0 mmol/L. He sustained a spinal cord injury 10 days ago. Why is suxamethonium contraindicated in this patient?