Can Succinylcholine be Used Safely in Severely Burn Patients?

The use of succinylcholine(SC) in burn patients are relatively contraindicated for certain period after lesion aged 4 days – 10 weeks due to chance of hyperkalemia although there are no systemic data to define what period and what level of K^+ is safe. This prospective study was carried out in 60 acute burn patients who were admitted in DMCH Burn Unit and undergone surgery within 3 months of lesion. Most common type of burn was flame burn (33%).Mean age of the patient was 22.60 ± 9.61, TBSA (Total burn surface area) was 22.17 ± 9.57 and duration of burn was 23.36 ± 19.61. Every patient received standard dose of SC (1.5mg/kg) for intubation. The peripheral venous blood samples for serum K^+, Na^+, Cl ^- HCO3^- were drawn before induction and 3 minutes after injection of SC. On analysis there were no significant change of serum K^+ and HCO3^- (p .05), on the other hand serum Na+and Cl^- levels were significantly changed (p 0.05) due to correction of dehydration. In case of electric burn serum K^+ level was raised in every cases but didn’t cross the normal high level of serum K^+ (5.5mEq/ l). Haemodynamic parameters like pulse, NIBP, SPO2 and ECG were analyzed intra operatively and there were no significant change in NIBP and ECG, rather there were significant improvement in pulse and SPO2 (p 0.05). Survival of anaesthetic was 100% and no dysrhythmias or major morbidity were found intra operatively. Therefore, these data taken in the context of a compelling case for rapid intubating condition suggest safety in succinylcholine use in the patients with acute burn.