Efficacy
Suxamethonium in combination with other drugs (analgesics and vagolytic agents) resulted in superior intubation conditions and a shorter procedure duration1-6. (Level II, Grade A)
For laparoscopic pyloromyotomy in term infants using propofol, sevoflurane and no intraoperative opioid, succinylcholine may be the neuromuscular blocking drug of choice, provided no contraindication is present4. (Level III-3, Grade B)
Safety
Suxamethonium has been very widely used, but has several rare side effects and causes an increase in blood pressure, simultaneously with depolarisation.1,2 (Level II Grade B)
Hyperkalaemia may occur, but major elevations are uncommon. It may trigger malignant hyperkalaemia, a rare autosomal dominant disorder of skeletal muscles that remain asymptomatic unless triggering substances are given. It should not be used in infants with hyperkalaemia or family history of malignant hyperthermia.1 (Level IV Grade D)
It can cause prolonged neuromuscular blockade requiring ventilation until spontaneous resolution occurs in infants with pseudocholinesterase deficiency.7 (Level IV Grade D)
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