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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Goodbye suxamethonium!

C Lee1

  • 1Department of Anesthesiology, Harbor-UCLA Medical Center, Torrance, CA, USA. chinglee@chinglee.net

Anaesthesia
|February 19, 2009
PubMed
Summary
This summary is machine-generated.

Suxamethonium, despite its problems, has been a cornerstone of neuromuscular pharmacology for decades. With the advent of sugammadex, this problematic anesthetic drug may finally be retired.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Neuromuscular Blockade

Background:

  • Suxamethonium has been a widely used anesthetic muscle relaxant for decades.
  • Despite numerous challenges and attempts at replacement, suxamethonium remains in clinical use.
  • It has played a significant role in teaching neuromuscular pharmacology and understanding side effects.

Purpose of the Study:

  • To provide a historical review and eulogy for suxamethonium.
  • To discuss the enduring legacy and problematic nature of suxamethonium in anesthesia.
  • To acknowledge the potential retirement of suxamethonium with the emergence of sugammadex.

Main Methods:

  • This is a review article, not an experimental study.
  • The authors synthesize existing knowledge and clinical experience with suxamethonium.
  • The review discusses the drug's history, pharmacology, side effects, and impact on patient care.

Main Results:

  • Suxamethonium has been problematic yet persistent in anesthesia practice.
  • It has been instrumental in advancing the understanding of neuromuscular pharmacology.
  • Millions of patients have benefited from its use despite its side effect profile.

Conclusions:

  • Suxamethonium has served its purpose in anesthesia and pharmacology.
  • The development of sugammadex suggests a potential end to suxamethonium's long clinical run.
  • It is time to acknowledge the contributions and potential retirement of suxamethonium.