Effect of Esmolol on Serum Potassium Changes Induced by Succinylcholine

Khil, Hong Mo; Lee, Myung Ae

Abstract

BACKGROUND: The purpose of this study was to determine whether esmolol augmented the increase in serum K+ following administration of succinylcholine.
METHODS
Forty patients were randomly divided esmolol group (n=20) and control group (n=20). The esmolol group received a 1 minute rapid infusion of 500 mcg/kg/min followed by a continuous infusion of 200 mcg/kg/min for 4 minutes before administration of succinylcholine. Serum potassium level, mean arterial blood pressure and pulse rate were measured prior to induction(baseline) and 1, 3, 5, 10, 15, 30, 45, 60, 75, 90 minutes after administration of succinylcholine.
RESULTS
Serum potassium level was significantly higher in esmolol group after 3 and 15 minutes after succinylcholine than control group. Mean arterial blood pressure was not significantly different between two groups except 10 minute but the pulse rate significantly lower 1, 3, 5, 10 and 15 minutes in esmolol group than control group.
CONCLUSIONS
Esmolol does not significantly elevate serum potassium level in clinical use(1 minute infusion of 500 mcg/kg/min followed by infusion of 200 mcg/kg/min for 4 minutes) after administration of succinylcholine. So succinylcholine can be used safely in the presence of beta-1-selective adrenergic blockade. And esmolol can attenuate more effectively increase of pulse rate than mean arterial pressure.