The Effect of Pretreatment of Atracurium with Succinylcholine on Serum Potassium Level

Providing safe and rapid air way conduction, is very important in the anesthesia of emergency patients because it reduces many complications due to delay in the endotrachal intubation. In this group of patients, administration of succinylcholin is not necessary. But, in certain conditions, it can cause a sudden increase of serum potassium level, and could cause cardiac arrest. Therefore use of non blocker dosage of non depolarizant neuromuscular blocker (defasciculation), for reducing this side effect is suggested. The aim of this study, is determine the effect of pretreatment atracurium on serum potassium level associated with administration of succinylcholine. This study was a clinical trial on 82 patients aged between 15-70 years with ASAI-II (American society of anesthesiology of physical status class) After administering premedication drugs to all patients, blood samples were taken, and they considered as control group, then pretreatment atracurium injection (50mcg/kg) and after three minutes, induction was performed with thiopental sodium (5mg/kg) and succinylcholine (1.5 mg/kg), and after 5 minutes, second blood sample was taken, as case group. Blood samples, were collected in to the espicial tube of serum potassium and serums were separated immediately. Then, potasiom level of serums were measured with micro light. The data were analyzed and compared through T-test and wilcoxon. According to the results, the mean of serum potassium level after administration of succinylcholine associated with defasciculation atracurium and before the administration of pretreatment atracurium (base level) was not significantly different. Administration of pretreatment atracurium is not effective in prevention of hyperkalemia induced by succinylcholin with attention base level.