Succinylcholine Is Safe in Renal Failure

Succinylcholine (SCh) causes a modest ( (less than) 0.5 mEq/L) rise in serum potassium in patients with normal renal function. Based primarily on case reports, many physicians believe that the rise is much greater in patients with acute or chronic renal failure. These investigators reviewed the English language literature to determine whether this concern is warranted.

In 4 controlled studies of patients with and without renal failure, potassium increases never exceeded 0.5 mEq/L, irrespective of pretreatment with a "defasciculating" dose of a competitive neuromuscular blocking agent. In 2 case series, 22 of 23 patients with chronic renal failure who received single or multiple doses of SCh had potassium increases of less than 0.7 mEq/L, and…