SUXAMETHONIUM-INDUCED HYPERKALAEMIA IN PATIENTS WITH SEVERE INTRA-ABDOMINAL INFECTIONS

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Abstract
SUMMARYIn nine patients, undergoing repeat operations because of severe intra-abdominal infection developing after major abdominal surgery, serum potassium concentrations were monitored during induction of anaesthesia. Four patients showed an increase of serum potassium ranging from 2.5 to 3.1 mmol/ litre above baseline values within 3–6 min after suxamethonium 100 mg i.v. In five patients there was no change. The four patients demonstrating an increase had suffered from pyrexia and leucocyt-osis for at least 2 weeks. The other five had signs of infection for no more than 9 days. It is concluded that patients with signs of severe intra-abdominal infection lasting longer than 1 week represent an additional category susceptible to suxamethonium-induced hyperkalaemia. They should receive only non-depolarizing muscle relaxants. When the use of suxamethonium is unavoidable, the injection of a non-depolarizing muscle relaxant before the administration of suxamethonium is recommended.

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