[Suxamethonium-induced hyperkalaemia in patients with severe intraabdominal infections (author's transl)]

A serious danger to the circulation following the administration of suxamethonium is known to occur in patients reacting with an abnormal release of potassium. So far the following groups of patients have been found to be at an increased risk: burns, multiple trauma, tetanus, neurological disorders, uraemia. As a result of our investigations patients with severe intraabdominal infections are also to be regarded as at risk. Four of ten patients with this diagnosis have shown an increase of serum-potassium of more than 2.5 mequiv/l following suxamethonium injection in spite of a prophylactic small dose of nondepolarizing relaxant. The predisposing factors are high fever of over a week's duration and a leucocytosis of more than 10,000/cu. mm. A possible hypothesis and pathogenesis of the abnormal efflux of potassium is discussed. Prophylaxis consists of using only nondepolarizing relaxants in these cases. When there is a special indication for suxamethonium the potassium increase can be lessened if the patient is given a small dose of nondepolarizing relaxant prior to the administration of suxamethonium.