Prevention of succinylcholine induced hyperkalemia by neurolept anesthesia and hexafluorenium in anephric patients

Forty patients, half of them with normal kidney function, the other half anephric were included in the study. All received diphenhydramine, meperidine and atropine for premedication and droperidol, fentanyl, N2O and O2 for anesthesia. For endotracheal intubation and further relaxation 0.3 mg/kg hexafluorenium, followed in 5 minutes by 0.2 mg/kg succinylcholine were given intravenously. Anesthesia was maintained by 0.5 micrograms/kg increments of fentanyl, muscle relaxation by increments of 0.15 mg/kg or less hexafluorenium and 0.2 mg/kg or less succinylcholine, depending on the surgical time requirements. The drop in serum potassium concentration was sustained and similar in both groups. In the anephric group the drop after induction of neurolept anesthesia was statistically significant. The concentration remained low in both groups over the entire observation period. Unchanged serum sodium excluded hemodilution and the fact that there was no significant change in PvCO2 and pH mitigates against alkalosis as the cause for the observed drop. The anesthesia and muscle relation, as described, appears to be a suitable and hazard free alternative to other techniques.