Muscle fasciculation caused by succinylcholine

Muscle Fasciculation Caused by Succinylcholine

Succinylcholine is a common paralytic drug used in surgeries, as well as for intubation, where a tube is inserted into the trachea providing oxygen to the lungs.

When used in surgery there are certain rare side effects that can arise, one of which is muscle fasciculations. These are involuntary muscle contractions that cause sudden and uncontrollable movements and facial twitching. This can be problematic as it may cause the patient distress or interfere with the procedure being performed, making it more difficult.

The exact cause of the fasciculations is not fully understood, however it is believed to be due to an efflux of calcium from the myofibrils. This can be related to other side effects of succinylcholine such as increased serum potassium, increased intracellular calcium, and increased skeletal muscle tension.

To lessen the chances of experiencing muscle fasciculations while being administered succinylcholine, it can be given in a short bolus with a low dose to start with. This can help to reduce the chances of the muscle contractions occurring. In addition, giving the medication either quickly or slowly can cause different effects, with the former making fasciculation more likely. It is therefore important to administer the drug correctly.

Other potential treatments include the use of lidocaine, B-blockers, magnesium and potassium supplementation, and even alternative paralytic medications. In some cases, the fasciculation may also resolve itself, however this can take time and will not be effective in more serious cases.

Points to remember

• Succinylcholine is a paralytic agent often used in surgeries and intubations.
• It can cause involuntary muscle contractions known as muscle fasciculations.
• These contractions can cause the patient distress and interfere with the procedure.
• The exact cause is unknown but is likely related to an efflux of calcium.
• The risk of fasciculation can be reduced by using low doses and administering the medication correctly.
• Other treatments include lidocaine, B-blockers, magnesium and potassium supplementation or alternative paralytic medications.