[Heart arrest in children after intravenous injection of succinylcholine in the ENT operating room].
Acute rhabdomyolysis with hyperkalemia has been followed by ventricular dysrhythmia, cardiac arrest and death after the administration of succinylcholine to apparently healthy children who were subsequently found to have undiagnosed skeletal muscle myopathies. Boys have mostly been affected. Reports of anesthesia emergencies from the United States and Germany have indicated that serious side effects of succinylcholine are not as rare as previously thought. This disorder often presents as sudden cardiac arrest within minutes after the administration of the drug. The tragedy is that an apparently healthy child dies abruptly during what was considered to be a relatively uncomplicated surgical procedure (most often in ENT surgery). Due to the abrupt onset of rhabdomyolysis, routine resuscitative measures are likely to be unsuccessful. Extraordinary measures (including institution of extracorporeal circulation) and prolonged efforts have resulted in successful resuscitation of some cases. Since there are usually no signs or symptoms to alert the practitioner to patients at risk, the use of succinylcholine in children should be reserved for emergency intubations or instances in which immediate securing of the airway is necessary.
Klinik für Anaesthesie und Operative Intensivmedizin, Städtisches Krankenhaus Heilbronn.
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D002648:Child; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D007275:Injections, Intravenous; D007431:Intraoperative Complications / Q000139:chemically induced*; D008297:Male; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D010038:Otorhinolaryngologic Diseases / Q000601:surgery*; D012151:Resuscitation; D012307:Risk Factors; D013390:Succinylcholine / Q000008:administration & dosage / Q000009:adverse effects*
D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine
Herzstillstand bei Kindern nach intravenöser Injektion von Succinylcholin im HNO-Operationssaal.