SERUM POTASSIUM CHANGES ON SUCCINYLCHOLINE: ASSISTED ENDOTRACHEAL INTUBATION IN EMERGENCY DEPARTMENT

Kim,  Moo Soo; A,  En Kyoung; Choi,  Ok Kyoung; Jung,  Koo Young

J Korean Soc Emerg Med > Volume 8(1); 1997 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1997;8(1): 36-41.

SERUM POTASSIUM CHANGES ON SUCCINYLCHOLINE: ASSISTED ENDOTRACHEAL INTUBATION IN EMERGENCY DEPARTMENT

Moo Soo Kim, En Kyoung A, Ok Kyoung Choi, Koo Young Jung

Department of Emergency Medicine, Ewha Womans University MokDong Hospital, Korea.

ABSTRACT

Succinylcholine is a depolarizing neuromuscular blocking agent(NMB) and is used in induction of anesthesia. Succinylcholine-assisted endotracheal intubation has been routinely used in the operating room and rapid sequence incubation with NMB agent has been the method for airway management in emergency department(ED). Adverse effects of succinylcholine are hyperkalemia, malignant hyperthermia, transient hypotension, arrhythmia, and increased intracranial, intraocular and gastric pressure, etc. This study carried out the change of serum potassium as an adverse effects of succinylcholine during endotracheal intubation in ED. A prospective, noncontrolled design was used to study serial serum potassium levels in pre- and postendotracheal intubation(5min) from February 1996 to August 1996. Succinycholine was selectively used in patient with a problem of difficult endotracheal intubation (alert to drowsy mental status with intact gag reflex). The dose of succinylcholine was 1.5 mg/kg and injected into intravenous line during preoxygenation with bag-valve-mask device. Student's two-tailed t-test was used and p-value was < 0.05. Among the total of 48 patients(male 27, female 21), the postintubation level of the serum potassium of 25 patients were increased and those of 21 persons were decreased compared with preintubation level. Two patients showed no change in amount. The average serum potassium indicated 3.7+/-.8 mEq/L before the injection of the succinylcholine and 3.8+/-.9 mEq/L 5 minutes after its injection. P-value showed more than 0.05 and as the result statistically there was no noteworthy difference. All patients were intubated within 30 sec and no patients were failed. We concluded that succinylcholine-assisted endotracheal incubation is a rapid and safe method as an endotracheal incubation practiced in ED and succinylcholin-induced hyperkalemia is minimal and no adverse effect.

Key words: Succinylcholine, Endotracheal intubation, Hyperkalemia