In burn patients more than 24 hours after injury, succinylcholine should be avoided due to the risk of which complication?

In burn patients more than 24 hours after injury, succinylcholine should be avoided due to the risk of which complication?

• A. Hypokalemia
• B. Hypocalcemia
• C. Hyperkalemia
• D. Hypermagnesemia

Answer: (C)

After a burn injury, skeletal muscle membranes develop many extrajunctional acetylcholine receptors, especially after the first day. When succinylcholine is given in this setting, those receptors cause a large efflux of potassium from muscle cells into the blood, leading to dangerous hyperkalemia. This rapid rise in potassium can trigger life-threatening arrhythmias or cardiac arrest, which is why succinylcholine is avoided more than 24 hours after burn injury. Nondepolarizing neuromuscular blockers are preferred instead.

After a burn injury, skeletal muscle membranes develop many extrajunctional acetylcholine receptors, especially after the first day. When succinylcholine is given in this setting, those receptors cause a large efflux of potassium from muscle cells into the blood, leading to dangerous hyperkalemia. This rapid rise in potassium can trigger life-threatening arrhythmias or cardiac arrest, which is why succinylcholine is avoided more than 24 hours after burn injury. Nondepolarizing neuromuscular blockers are preferred instead.