Abstract: Suxamethonium chloride is a depolarizing muscle relaxant used in general anesthesia. In overdose, it causes adverse reactions such as bradycardia, arrhythmia, cardiac arrest, and death. The article reviews the progress on testing methods of suxamethonium chloride such as infrared spectroscopy, chemical color reaction, chemical titration, enzyme electrode, chromatography and mass spectrometry.
Anesthesia, General ; Arrhythmias, Cardiac/chemically induced* ; Biosensing Techniques ; Bradycardia/chemically induced* ; Chromatography ; Drug Overdose ; Heart Arrest/chemically induced* ; Humans ; Mass Spectrometry ; Neuromuscular Depolarizing Agents/analysis* ; Spectrophotometry, Infrared ; Succinylcholine/analysis*

Malignant hyperthermia is a genetically transmitted, catastrophic, hypermetabolic syndrome that is induced by potent volatile anesthetics and/or depolarizing muscle relaxants. It is now well established that the pathophysiology is related to a malfunction of the intracellular calcium homeostasis in skeletal muscle. Morbidity has been correlated to the duration of symptoms. Dantrolene decreased release of calcium from the sarcoplasmic reticulum. We recently encountered a fulminant case during halothane anesthesia. Anesthesia was induced with thiopental and succinylcholine without jaw tightness or stiffness. After induction, tachycardia, arrhythmias, increased end-tidal CO2, and high body temperature were noted. Arterial blood gas analysis showed a severe, mixed acidosis. Intensive treatment with body cooling was immediately initiated. But dantolene could not be available. The patient died of renal failure and disseminated intravascular coagulation 41 hours after induction of anesthesia.
Acidosis ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Arrhythmias, Cardiac ; Blood Gas Analysis ; Body Temperature ; Calcium ; Dantrolene ; Disseminated Intravascular Coagulation ; Halothane ; Homeostasis ; Humans ; Jaw ; Malignant Hyperthermia* ; Muscle, Skeletal ; Neuromuscular Depolarizing Agents ; Renal Insufficiency ; Sarcoplasmic Reticulum ; Succinylcholine ; Tachycardia ; Thiopental