Pang Yu-Li, Tseng Fan-Ling, Tsai Yu-Chuan, Liu Yen-Chin
Department of Anesthesiology, National Cheng Kung University Medical College, Tainan, Taiwan.
Crit Care Resusc. 2006 Sep;8(3):213-4.
The use of suxamethonium (succinylcholine) for rapid-sequence intubation may be limited by hyperkalaemia. Modest pre-induction hyperkalaemia is usually disregarded. We present a patient who underwent emergency surgery for a perforated peptic ulcer after being bedbound for 26 days because of a head injury. Serum potassium level was 4.0 mmol/L. The patient was intubated after injection of sedative and suxamethonium and, about 3 minutes later, developed ventricular arrhythmia. Blood tests during resuscitation showed a serum potassium level of 8.8 mmol/L. Immobilisation, denervation and intra-abdominal infection were risk factors for hyperkalaemia in this patient. This report reinforces the need to identify risk factors for hyperkalaemia before administration of suxamethonium, even when serum potassium levels are normal.
琥珀酰胆碱用于快速顺序诱导插管可能会受到高钾血症的限制。轻度的诱导前高钾血症通常被忽视。我们报告一名患者，因头部受伤卧床26天后因消化性溃疡穿孔接受急诊手术。血清钾水平为4.0 mmol/L。患者在注射镇静剂和琥珀酰胆碱后插管，约3分钟后出现室性心律失常。复苏期间的血液检查显示血清钾水平为8.8 mmol/L。制动、去神经支配和腹腔内感染是该患者高钾血症的危险因素。本报告强调，即使血清钾水平正常，在给予琥珀酰胆碱之前也需要识别高钾血症的危险因素。
