Succinylcholine-Induced Increases in Plasma Catecholamine Levels in Man : Modification by Alcuronium Pretreatment

The effects of succinylcholine alone (8 patients) or with alcuronium pretreatment (7 patients) on plasma levels of norepinephrine (NE) and epinephrine (E) were studied during enflurane anesthesia. Plasma levels of NE and E were determined immediately before and 1, 3, 5 and 10 min after intravenous administration of succinylcholine 1 mg/Kg. At the same time intervals, mean blood pressure and heart rate were measured. Blood gas values, enflurane and electrolytes concentration in the plasma were remained unchanged throughout the study. Without pretreatment, NE and E levels and mean blood pressure and heart rate increased significantly either at 1, 3 or 5 min after succinylcholine, and then returned to the control values at 10min. The peak increases in NE and E were 157% of control at 3 min and 177% 5 min, respectively. Alcuronium pretreatment attenuated the succinylcholine-induced increases in NE, E, mean blood pressure and heart rate. Although the underlying mechanism of the attenuation produced by alcuronium remains unclear, this study suggests that in clinical practice the use of succinylcholine must be cautious in patients with ischemic heart diseases.