In this episode, I had the privilege of chatting with Michael Mielniczek, BSN, SRNA on an overview of succinylcholine.

At the time of this recording, Michael was a second year Student Registered Nurse Anesthetist at the University of Scranton and a student representative for the AANA Foundation.  His background includes experience as a critical care Registered Nurse in Austin and achieving nursing certifications in critical care (CCRN), cardiac medicine (CMC) and cardiac surgery (CSC).   As part of his graduate studies, Michael completed an in-depth project regarding the history, latest research and controversies on succinylcholine titled “Succinylcholine:  From Discovery to Current Evidence for Everyday Practice,” which is also the title of his podium presentation at the 2018 national AANA Nurse Anesthetists Annual Congress in Boston.

Michael contacted me with a desire to share what he’s learned on succinylcholine with our podcast listeners and I couldn’t be more pleased to bring you this episode.

In the episode, we cover an in-depth overview of succinylcholine pharmacology, dosing, considerations and controversies.

While our conversation is strictly based on published anesthesia textbooks and published, peer-reviewed journal articles, we both strongly encourage you to cross-reference any and all information, especially on dosing, with published resources.

The resources we pulled from for this conversation are below:

Alvarellos, M. L., McDonagh, E. M., Patel, S., McLeod, H. L., Altman, R. B., & Klein, T. E. (2015). PharmGKB summary: succinylcholine pathway, pharmacokinetics/pharmacodynamics. Pharmacogenetics and genomics, 25(12), 622.

Barash, P. G. (Ed.). (2009). Clinical anesthesia. Lippincott Williams & Wilkins.

Fukano, N., Suzuki, T., Ishikawa, K., Mizutani, H., Saeki, S., & Ogawa, S. (2011). A randomized trial to identify optimal precurarizing dose of rocuronium to avoid precurarization-induced neuromuscular block. Journal of anesthesia, 25(2), 200-204.

Lee, C. (2003). Conformation, action, and mechanism of action of neuromuscular blocking muscle relaxants. Pharmacology & therapeutics, 98(2), 143-169.

Nagelhout, J. J., & Plaus, K. L. (2014). Nurse anesthesia. Elsevier Health Sciences.

Miller, R. D. (2015). Miller’s anesthesia (8th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier.

Schreiber, J. U., Lysakowski, C., Fuchs-Buder, T., & Tramer, M. R. (2005). Prevention of Succinylcholine-induced Fasciculation and MyalgiaA Meta-analysis of Randomized Trials. Anesthesiology: The Journal of the American Society of Anesthesiologists, 103(4), 877-884.

Tran, D. T., Newton, E. K., Mount, V. A., Lee, J. S., Wells, G. A., & Perry, J. J. (2015). Rocuronium versus succinylcholine for rapid sequence induction intubation. The Cochrane Library.