© 2005 BMJ Publishing Group Ltd, and British Association for Accident and Emergency Medicine
CASE REPORT
Succinylcholine induced masseter spasm during rapid sequence intubation may require a surgical airway: case report
1 4th Infantry Division, 2nd Brigade, Surgeon Section, Fort Hood, TX 76544, USA
2 Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
3 Wilford Hall Medical Center, Department of Emergency Medicine, Lackland Air Force Base, TX 78236, USA
Correspondence to:
Correspondence to:
S J Bauer
sberdoc@aol.com
Accepted 19 August 2004
Keywords: cricothyroidotomy; masseter; spasm; succinylcholine
| The first 150 words of the full text of this article appear below. |
Succinylcholine has long been the neuromuscular blockade agent of choice for the emergency physician for rapid sequence intubation because of its rapid onset and relatively brief duration of action. However, it has many known life-threatening side effects and contraindications including allergy, histamine release, dysrhythmias, hyperkalaemia, and malignant hyperthermia.1 It has also been known to cause significant masseter spasm in children when used in conjunction with volatile anaesthetics such as halothane.2–5 In adults, succinylcholine can also produce transient masseter spasm that resolves when fasciculation stops. This potentially deadly side effect has been noted in other specialties but the incidence in adults is unknown.6,7 The generally agreed upon treatment is to stop the anaesthetic and reschedule the procedure at a later date with different agents and evaluation for malignant hyperthermia.4 However, in the emergency department that management option is not available to the emergency physician. Knowledge of the potential side effects of
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- Complications following attempted rapid sequence intubation
- Jonathan Hulme
- EMJ Online, 13 Jun 2005 [Full text]
- Re: complications following attempted rapid sequence intubation
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- EMJ Online, 2 Aug 2005 [Full text]
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