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Published on: July 3, 2013

Calcium channel blockers do not enhance increases in plasma potassium after succinylcholine in humans

G A Rooke1, P R Freund, J Tomlin

  • 1Department of Anesthesiology, University of Washington School of Medicine, Seattle.

Journal of Clinical Anesthesia
|March 1, 1994
PubMed

Insights

Chronic calcium channel blocker therapy does not increase the risk of hyperkalemia after succinylcholine administration. This study found no significant difference in plasma potassium levels between patients on these medications and those who were not.

Area of Science:

  • Anesthesiology
  • Clinical Pharmacology
  • Cardiovascular Medicine

Background:

  • Calcium channel blockers (CCBs) are widely used for cardiovascular conditions.
  • Succinylcholine administration can cause a transient rise in plasma potassium.
  • Potential for CCB therapy to exacerbate succinylcholine-induced hyperkalemia is a clinical concern.

Purpose of the Study:

  • To investigate whether chronic calcium channel blocker therapy alters the plasma potassium response to succinylcholine.
  • To assess the risk of hyperkalemia in patients on CCBs undergoing procedures requiring succinylcholine.

Main Methods:

  • Prospective clinical study conducted at university and Veterans Affairs hospitals.
  • 36 male patients (ASA III-IV) were divided into two groups: 21 on chronic CCBs and 15 not on CCBs.
  • Anesthesia induced with opioids and hypnotics, followed by succinylcholine (1-1.5 mg/kg) for intubation without neuromuscular blocker pretreatment.

Main Results:

  • Plasma potassium levels were monitored for 15 minutes post-succinylcholine administration.
  • A modest average peak increase of 0.5 mEq/L in plasma potassium was observed.
  • No significant difference in plasma potassium rise was detected between patients receiving CCBs and those who were not.

Conclusions:

  • Chronic calcium channel blocker therapy does not appear to increase the risk of hyperkalemia following succinylcholine administration.
  • Patients on CCBs can be safely administered succinylcholine without an exaggerated potassium response.
  • Findings suggest current CCB use does not necessitate modification of succinylcholine protocols regarding hyperkalemia risk.
Abstract

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