Which electrolyte disturbance can occur with succinylcholine administration in neonates?

Which electrolyte disturbance can occur with succinylcholine administration in neonates?

• A. Hypokalemia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypomagnesemia

Answer: (B)

The main concept is that a depolarizing neuromuscular blocker can cause potassium to leak out of muscle cells, raising serum potassium. In neonates, the developing muscle membrane has more extrajunctional acetylcholine receptors. When succinylcholine binds and depolarizes the motor endplate across these widespread receptors, a large amount of potassium is released into the extracellular space. This can lead to marked hyperkalemia and, in severe cases, life-threatening arrhythmias or cardiac arrest. Because of this risk, hyperkalemia is the electrolyte disturbance you’d expect with succinylcholine in neonates. The other electrolyte disturbances listed are not typical consequences of succinylcholine in this age group.

The main concept is that a depolarizing neuromuscular blocker can cause potassium to leak out of muscle cells, raising serum potassium. In neonates, the developing muscle membrane has more extrajunctional acetylcholine receptors. When succinylcholine binds and depolarizes the motor endplate across these widespread receptors, a large amount of potassium is released into the extracellular space. This can lead to marked hyperkalemia and, in severe cases, life-threatening arrhythmias or cardiac arrest. Because of this risk, hyperkalemia is the electrolyte disturbance you’d expect with succinylcholine in neonates. The other electrolyte disturbances listed are not typical consequences of succinylcholine in this age group.