If you or someone in your family is going to have surgery, the anesthetist will use various medications to put you to sleep, make you feel no pain, and make the surgery safe. One of these is a special, and very important, medication called Succinylcholine. It works by temporarily relaxing your muscles. So, let's talk briefly about this medication, what it does, and what you need to know before using it.
Simply put, what is Succinylcholine?
Succinylcholine is a skeletal muscle relaxant . Imagine, this is like temporarily losing some of the muscles in our body that we control mentally, such as those in our limbs, neck, and stomach. But this is temporary.
This medicine is mainly used in two situations:
1. During surgery: During surgery, especially abdominal surgery, if the muscles in the body are tense, it is difficult for the surgeon to perform the operation. Since the muscles are completely relaxed when this medicine is given, the surgery can be performed easily and safely. Also, sometimes it is necessary to put a tube through the neck (intubation) to help with the breathing process. This medicine is also used at that time.
2. When connected to a ventilator: When someone is having difficulty breathing on their own and is connected to a ventilator, the muscles in that person's body can interfere with the operation of the machine. In such cases, this medicine is given to relax the muscles and allow the ventilator to work properly.
The most important thing is that this is not a medicine that you can use at home. It is only used in a hospital, intensive care unit, or operating room, under the close supervision of trained doctors and nursing staff.
Things you should definitely tell your doctor before giving this medicine
This is a very important part. For your safety, it is essential to inform the anesthesiologist about certain conditions in your body before the surgery. Because based on that information, the decision will be made whether to give you this medicine or not, or whether to give you a different medicine.
If you have any of the conditions below, be sure to tell your doctor about it.
| Your medical condition or condition | Why should you inform? |
|---|---|
| Allergies | If you have an allergy to succinylcholine or any other medicine, food, or dye. |
| Family medical history | If anyone in your family has had an anesthesia-related problem (e.g., Malignant Hyperthermia). |
| Muscle-related diseases | If you have a muscle-weakening disease like Myasthenia Gravis. |
| Eye problems | Conditions with increased eye pressure, such as glaucoma. |
| Mineral levels in the blood | If the levels of potassium, calcium, or magnesium in the blood are high or low. |
| Injuries | Serious head injuries, major burns, or extensive skin damage. |
| Pregnancy | If you are pregnant, trying to get pregnant, or breastfeeding. |
Can this medicine be given to small children?
Yes, in some special cases, this medicine can be prescribed to children, starting from newborns. But special precautions are followed. This decision is made together by your child's pediatrician and anesthesiologist.
What if the dose increases?
This is given in a hospital, under medical supervision, so the chance of you overdosing is very low. The medical staff will calculate the correct dose based on your weight and condition and administer the medicine. If this happens, they are trained to provide the necessary treatment. If you need any information about this, you can call the National Poisons Information Centre at the Colombo National Hospital for details. However, in any emergency, the best thing to do is to go to the nearest Emergency Treatment Unit (ETU) .
Other medications that may interact with this medicine
It is very important to tell your doctor about all the medications you are taking (medicines for other conditions, vitamins, traditional medicines, supplements). Some medications can interact with Succinylcholine, changing its effects or causing dangerous conditions.
Below are some such drugs:
- Certain antibiotics: for example, amikacin, gentamicin, clindamycin.
- Other anesthetic drugs: Gas anesthetics such as enflurane, isoflurane, halothane.
- Medicines for heart disease and high blood pressure.
- Birth control pills.
- Lithium: A medication used for mental illness.
- MAOIs: A type of medication given for depression.
- Types of steroids: For example, prednisone or cortisone.
- Medicines containing magnesium.
- Quinine: A medicine used for malaria.
This list is not exhaustive. Therefore, be honest with your doctor about all medications you take, and whether you smoke or drink alcohol .
What are the possible side effects of the medicine?
As with any medication, Succinylcholine can cause side effects. You will be closely monitored, so if there are any problems, the medical team will take immediate action.
| Side effect | Description |
|---|---|
| Things to tell your doctor or nursing staff immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips or tongue. |
| Difficulty breathing | If you are not on a ventilator, feeling short of breath. |
| Changes in heart rate | Abnormally slow or fast, irregular heartbeat. Chest pain. |
| Symptoms of high potassium | Extreme muscle weakness, chest pain. |
| Symptoms of muscle damage | Dark urine, difficulty urinating, extreme fatigue, muscle pain. |
| Symptoms of low blood pressure | Dizziness, blue eyes, extreme weakness. |
| Things that are usually not serious, but should be reported if they persist | |
| Muscle pain | It is normal to experience body and muscle pain for a day or two after the effects of the medication wear off. |
| Muscle weakness | Temporary muscle weakness. |
Take-Home Message
- Succinylcholine is a powerful muscle relaxant used only in hospitals, especially in surgical and intensive care units.
- Before you are given this medicine, it is essential that you tell your doctor about your complete medical history, allergies, family medical history, and all other medications you are taking.
- Because this is given by trained doctors, you don't have to worry about storing or administering it.
- Although side effects are possible, they can be managed by the medical team because you are under close observation in the hospital.
- If you have any concerns or questions, never be afraid to ask the anesthesiologist or your treating physician. Your safety is their top priority as well.
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