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Anaesthesia Muscle Relaxant a871a090

Muscle relaxant associated with increased ICP is?

A
Mivacurium
B
Atracurium
C
Suxamethonium
D
Vecuronium
High-Yield Explanation
Ans. is 'c' i.e., Suxamethoneum * Sch causes increases in all pressures - intraocular, intracranial, BP, and intrabdominalSuccinylcholine (Suxamethonium)* SCh is a depolarising skeletal muscle relaxant.* It causes sustained partial depolarization of muscle end plate - Initially produce twitching and fasciculation followed by flaccid paralysis.* It is the shortest and fastest acting skeletal muscle relaxant.* It is the only muscle relaxant which stimulate autonomic ganglia and vagus - Bradycardia occurs due to vagal stimulation.* SCh is the most commonly used muscle relaxant for passing endotracheal tube (rapacuronium and rocuronium are alternatives).* SCh is rapidly hydrolysed by plasma cholinersterase, some patients have genetically determined abnormality or deficiency of pseudocholinesterase, in them, SCh causes phase II block (dual block).* It can cause muscle fasiculations and soreness, change in BP and HR, arrhythmia, histamine release and K+ effux from muscles.* Post-operative muscle pain (myalgia, muscle soreness) is a very common problem.* It can accentuate malignant hyperthermia caused by halothane - Succinylcholine is the most common cause of malignant hyperthermia.* Succinylcholine can cause dangerous hyperkalemia in patients with: -# Burn# Massive trauma# Crush injury# Severe intra-abdominal infection# Spinal cord injury# Hemiplegia/Paraplegia# Muscular dystrophy# GB syndrome# Rhabdomyolysis# Severe Parkinsonism# Tetanus# Polyneuropathy# Closed head injury# Stroke# Encephalitis# Mysthenia gravis* SCh causes increases in all pressures -> intraocular, intracranial, BP, and intrabdominal.* SCh can cause Trismus (masseter spasm) especially in patients susceptible for malignant hyperthermia.

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