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عمومی::
سوکسینیل کولین، ساکسینیل کولین
* Succinylcholine is a blocking agent that produces depolarization at the endplate and binds to
The controversy regarding neuromuscular blocking agents and awareness is complicated by the fact that neuromuscular blockade seems to affect the bispectral index (BIS), which is the most widely used measure of unconsciousness.5 Reductions in BIS have been reported in awake individuals receiving succinylcholine and in mildly sedated patients given mivacurium.
Succinylcholine has virtually no effect on these presynaptic receptors, which would explain the lack of fade observed with this drug.17 Fade constitutes a key property of nondepolarizing neuromuscular blocking drugs and is
The only depolarizing agent still in use is succinylcholine.
Depolarizing Drugs: Succinylcholine،Succinylcholine
Succinylcholine can produce modest increases (~5 mm Hg) in ICP in lightly anesthetized humans.
Although succinylcholine can produce increases in ICP, it can still be used for a rapid sequence induction of anes- thesia.
No change in ICP was observed after the adminis- tration of succinylcholine, 1 mg/kg, to 10 nonparalyzed, ventilated neurosurgical patients in the intensive care unit, 6 of whom had sustained a head injury.191 Their obser- vations are relevant because it is in precisely this popula- tion of patients that the issue of the use of succinylcholine arises most frequently.
Considering that the ICP effects of succinylcholine may be an arousal phenomenon caused by increased afferent traffic from muscle spindles,189 it is rea- sonable to assume that disease processes that substantially blunt the level of consciousness might similarly blunt this response.
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