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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Is succinylcholine appropriate or obsolete in the intensive care unit? | Available online http ccforum.eom content 5 5 245 Commentary Is succinylcholine appropriate or obsolete in the intensive care unit Leo HDJ Booij Institute for Anaesthesiology University Hospital Nijmegen Sint Radboud Nijmegen The Netherlands Correspondence Leo HDJ Booij l.booij@anes.azn.nl Published online 31 August 2001 Critical Care 2001 5 245-246 2001 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Muscle relaxants in intensive care unit ICU patients are predominantly administered to facilitate intubation. The adverse effect profile of succinylcholine is such that its use in the ICU must be considered obsolete. Suitable alternatives are the intermediately long-acting nondepolarizing relaxants of which rocuronium is probably preferable. Keywords cholinesterase depolarizing muscle relaxants intubation neuromuscular nondepolarizing agents succinylcholine The use of muscle relaxants in intensive care patients is rapidly declining. The most important reason for this is the apparent development of a nondepolarizing relaxant-induced neuropathy which leads to difficulty in weaning patients from artificial ventilation among other problems 1 . Some frequently used drugs such as corticosteriods and aminoglycoside antibiotics contribute to this neuropathy 2 . Therefore nowadays relaxants are only administered in the ICU for specific indications such as when decreased muscle tone is required for treating patients who fight the ventilator and in order to allow permissive hypercapnia. Relaxants are still needed frequently in surgical anaesthesia to facilitate quick procedures such as endotracheal intubation. The depolarizing muscle relaxant succinylcholine is often used for this purpose. Its ultra-short duration of action renders rapid return of spontaneous breathing possible if intubation fails. The situation in the ICU is different however. During anaesthesia intubation and artificial ventilation are only indicated to facilitate surgery by ensuring an
