Suxamethonium and critical illness polyneuropathy

Administration of suxamethonium to patients with critical illness polyneuropathy may produce life-threatening hyperkalaemia. A questionnaire to assess the awareness of this problem was sent to all UK intensive care units. A clinical scenario suggestive of critical illness polyneuropathy was accompanied by a list of possible drugs used to facilitate endotracheal intubation. Most respondents (68.7%) chose suxamethonium while 20.4% avoided any muscle relaxant. This result suggests a worrying lack of appreciation of the dangers of suxamethonium use in critical illness polyneuropathy.