Case: A relatively innocuous case concerning the transportation of a Parkinson’s disease1 sufferer lead onto that age-old discussion about our old friend the depolarising neuromuscular blocker2 and which weird and wonderful neurological or neuomuscular problems it could or should not be used for.
Challenge: To use sux or not to use sux, that is the question.
Learning points: The figure below highlights those conditions where careful consideration of the use of Sux is indicated3 4. Your next line of defence is Rocuronium. Given in sufficient doses, Roc has as quick an onset time as Sux in a practical setting5.
1. Parkinson’s Disease and Anaesthesia
Indian J Anaesth. 2011 May-Jun; 55(3): 228–234 Free full text
5. Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: a prospective, randomized trial in emergent cases.
Anesth Analg 2005; 101:1356–61 Free full text
“Quod medicina aliis, aliis est acre venenum”