Canadian Anaesthetists’ Society Journal

, Volume 17, Issue 5, pp 477–484 | Cite as

Prevention of succinylcholine-induced hyperkalaemia by magnesium sulfate

  • J. Antonio Aldbete
  • Andres Zahler
  • Jerry K. Aikawa


By the previous intravenous administration of 1 gm of magnesium sulfate, the muscle fasciculations produced by succinylcholine were prevented in 18 (30 per cent) and ameliorated in 24 (40 per cent) of a group of 60 patients induced with sodium thiopental. Serum calcium, magnesium, and potassium concentrations were determined before and five minutes after injection of the drugs. Patients receiving MgSO4 (1 or 2 gm) had increases in Mg+ + and reduction of Ca++ and K+ even when muscle fasciculations were evident. Thiopental and succinylcholine administration produced slight diminutions of serum Mg+ + and Ca+ + and rises of K+. When d-tubocurarine was substituted for MgSO4 in the sequence of injections, muscle fasciculations were hindered, K+ values decreased slightly, and Ca+ + and Mg+ + levels were barely altered.

It is inferred that the rise of Mg+ + concentration in serum resulting after the injection of MgSO4 might impede muscle end-plate depolarization by decreasing the amount of acetylcholine quanta released by the nerve ending, and/or by sensitizing the same receptor site.


Thiopental Succinylcholine Magnesium Sulfate CANADIAN Anaesthetist Neuromuscular Transmission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Par administration préalable de 1 gramme de sulfate de magnésium intraveineux, les fasciculations musculaires produites par la succinylcholine ont été prévenues dans 18 cas (30 pour cent) et améliorées dans 24 cas (40 pour cent) chez un group de 60 patients, ľinduction étant réalisée par thiopental sodium. Les concentrations de calcium, magnésium et potassium sanguins ont été déterminées avant et 5 minutes après injection. Les patients recevant MgSO4 ( 1 ou 2 grammes) ont presenté une augmentation du magnésium et une diminution du calcium et du potassium, même quand les fasciculations musculaires étaient très nettes.

Ľadministration de thiopental et de succinylcholine produit une légère diminution des taux sériques du magnésium et du calcium et une augmentation du potassium. Quand la d-tubocurarine était substituée au MgSO4 lors des injections, les fasciculations musculaires étaient prévenues, les valeurs du potassium sanguin diminuaient légèrement, et le calcium et le magnésium étaient peu altérés.

Nous pensons que ľaugmentation du taux serique du magnésium, secondaire à ľinjection de MgSO4 doit agir au niveau de la plaque motrice en créant une dépolarisation par diminution du taux ďacetylcholine libérée par le nerf, et/ou en sensibilisant le recepteur lui-même.


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Copyright information

© Canadian Anesthesiologists 1970

Authors and Affiliations

  • J. Antonio Aldbete
    • 1
  • Andres Zahler
  • Jerry K. Aikawa
  1. 1.Department of AnesthesiologyUniversity of Miami School of MedicineMiami

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