Influence of pancuronium of potassium efflux produced by succinycholine

Serum potassium (K+) levels were measured after thiopental, succinylcholine, pancuronium, and pretreatment with pancuronium prior to succinylcholine, in 100 patients divided into 4 groups of 25 patients each. Significant increases in serum K+ were found after succinylcholine (1 mg/kg). Administration of pancuronium in small doses (20 mug/kg) prior to succinylcholine (1 mg/kg) was effective not only in complete prevention of serum K+ elevation but also produced consistent decrease in serum K+ concentration below control values. Both thiopental and pancuronium produced moderate fall in serum K+ levels. Our observations indicate that pretreatment with pancuronium may play a beneficial role in patients at risk from succinylcholine hyperkalemia.