Suxamethonium Is Dangerous in Polyneuropathy
Summary (1 min read)
- Case 1-A 23-year-old woman developed weak arms and legs and diplopia during her second pregnancy.
- On examination she had a mild peripheral sensory disturbance, definite distal muscle weakness, and absent tendon reflexes.
- Cerebrospinal fluid (CSF) protein was 2-0 g/l.
- The neuropathy relapsed over the next five years until she presented with deteriorating pulmonary function and an inability to cough due to muscle weakness, for which she required artificial ventilation.
- She was given atropine and thiopentone to induce anaesthesia and then paralysed with suxamethonium before intubation.
- During this procedure she developed a ventricular tachycardia, which returned promptly to sinus rhythm with intravenous lignocaine and DC cardioversion.
- Case 2-A 42-year-old man presented with paraesthesia in the hands and feet and left-sided facial weakness.
- Over the next seven months his arms and legs became progressively weak, extending proximally.
- He was almost completely paralysed in the arms, legs, and trunk and had a peripheral sensory disturbance and absent reflexes.
- His pulse was lost immediately, and ECG monitoring showed ventricular tachycardia, which progressed to ventricular fibrillation.
- Hp developed purulent sputum and a chest radiograph showed consolidation in the right lower lobe.
- Because he was unable to cough and blood gas concentrations were falling he was intubated, artificial.
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Cites background from "Suxamethonium Is Dangerous in Polyn..."
...Occasionally, fatal hemodynamic crises have been observed in, but not limited to, patients with burns (l), tetanus (2), spinal cord or lower motor neuron injuries (3), polyneuropathy (4), or previous irradiation (5)....
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Q1. What are the contributions in this paper?
In this paper, a 23-year-old woman developed weak arms and legs and diplopia during her second pregnancy, and was given atropine and thiopentone to induce anaesthesia and then paralysed with suxamethonium ( succinylcholine ) before intubation.