Sux in neuromuscular disease

After the administration of succinylcholine, an 0.5 – 1.0 mEq/mL increase in serum potassium is normal.

Patients with neuromuscular disease such as a stroke have risk of serious hyperkalemia after succinylcholine. This usually peaks 7-10 days after insult, but increased K+ release may occur as soon as 2-4 days after denervation injury, or after several days of immobility. Duration of risk has not been adequately characterized but is suspected to be for 3-6 months. Our current understanding of this phenomenon is incomplete, but is thought to be related to the up-regulation (increase) of AChRs. Note that renal failure itself does not place patients at risk for exaggerated release ] and succinylcholine can be administered, although the margin for error is lower.

Dunn agrees that renal failure itself does not increase the risk of SCh administration as long as hyperkalemia is well-controlled.