뇌성마비 환자에서 Succinylcholine으로 인한 혈중 전해질 농도의 변화

Abstract

Suceinylcholine(SCC)-induced hyperkalemia due to mechanical neuromuscular defects sueh as burn, severe trauma, uremia, neuromuscular diseases and etc. is well recognized from 1950. The upper motor neuron diseases are categorized into these neuromuscular diseases. For cerebral palsy, one of the upper motor neuron diseases, there are many different opinions in hyperkalemia after the administration of SCC. To establish the effects of SCC on hyperkalemia, in children with cerebral palsy presenting for selective posterior rhizotomy under the monitoring of evoked EMG, serum potassium, sodium, calcium, chloride and creatine phosphokinase (CPK) were measured prior to, and 2, 5, 10 and 30 min after the administration of SCC. The results are as follows,; 1) The mean age and body weight in twenty patients were 4.4+/-1.4 years and 14.2+/-2.1 kg, respectively. 2) Fine fasciculation on the hand, 1 graded by Cullen, occurred only in five of twenty patients. 3) There is no significant increase in the concentrations of potassium (ranges of mean ; 4.16- 4.23 mEq/L) and CPK (ranges 2.43-295 mEq/L) with the administration of SCC until 30 min. . 4) No significant changes in sodium, calcium and chloride following SCC are revealed. In conclusion,succinylcholine does not produce an increase in plasma potassium in children with cerebral palsy. However, CPK levels trend to increase after the administration, even if there is no statistically significant difference in the levels at the different time sequences.