{"id":752,"date":"2026-08-20T17:07:20","date_gmt":"2026-08-20T15:07:20","guid":{"rendered":"https:\/\/4beauty.de\/glossar\/succinylcholin-nebenwirkungen\/"},"modified":"2026-08-28T11:48:11","modified_gmt":"2026-08-28T09:48:11","slug":"succinylcholine-side-effects","status":"publish","type":"glossary","link":"https:\/\/4beauty.de\/en\/glossar\/succinylcholin-nebenwirkungen\/","title":{"rendered":"Succinylcholine side effects: definition, risks and contraindications"},"content":{"rendered":"<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Succinylcholine side effects<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Succinylcholine (suxamethonium, ATC code M03AB01) is the only depolarising muscle relaxant used in human medicine. Its side effects include fasciculations, hyperkalaemia, cardiac arrhythmias and \u2014 rarely \u2014 life-threatening malignant hyperthermia. Pharmacological antagonism is not possible.<\/p>\n<\/div>\n\n\n\n<div class=\"wp-block-rank-math-toc-block\" id=\"rank-math-toc\"><h2>Table of Contents<\/h2><nav><ul><li class=\"\"><a href=\"#wie-funktioniert-succinylcholin-wirkmechanismus-und-pharmakokinetik\">How does succinylcholine work? Mechanism of action and pharmacokinetics<\/a><\/li><li class=\"\"><a href=\"#succinylcholin-nebenwirkungen-ubersicht-nach-organsystemen\">Succinylcholine side effects: an overview by organ system<\/a><\/li><li class=\"\"><a href=\"#faszikulationen-und-postoperative-myalgien\">Fasciculations and post-operative myalgia<\/a><\/li><li class=\"\"><a href=\"#hyperkaliamie-kaliumanstieg-als-herzrisiko\">Hyperkalaemia: elevated potassium levels as a cardiac risk factor<\/a><\/li><li class=\"\"><a href=\"#maligne-hyperthermie-seltene-notfallkomplikation\">Malignant hyperthermia: a rare emergency complication<\/a><\/li><li class=\"\"><a href=\"#kardiovaskulare-effekte-bradykardie-und-herzrhythmusstorungen\">Cardiovascular effects: bradycardia and cardiac arrhythmias<\/a><\/li><li class=\"\"><a href=\"#anstieg-des-augeninnendrucks-risiko-bei-glaukom-und-offenen-augenverletzungen\">Increased intraocular pressure: a risk factor in glaucoma and open eye injuries<\/a><\/li><li class=\"\"><a href=\"#kontraindikationen-wann-ist-succinylcholin-ungeeignet\">Contraindications: When is succinylcholine unsuitable?<\/a><\/li><li class=\"\"><a href=\"#succinylcholin-vs-rocuronium-vergleich-und-entscheidungskriterien\">Succinylcholine vs. Rocuronium: Comparison and Decision-Making Criteria<\/a><\/li><li class=\"\"><a href=\"#narkosekomplikationen-bei-schonheitsoperationen-finanzielle-absicherung\">Anaesthetic complications in cosmetic surgery: financial protection<\/a><\/li><li class=\"\"><a href=\"#haufig-gestellte-fragen-zu-succinylcholin-nebenwirkungen\">Frequently Asked Questions about the side effects of succinylcholine<\/a><\/li><\/ul><\/nav><\/div>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-white-warm-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Important note<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This article is for information purposes only and is not a substitute for a medical diagnosis or advice. If you are unsure, or if you require a personalised treatment plan, it is essential that you consult a qualified specialist.<\/p>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Anyone planning cosmetic surgery will usually come into contact with the active ingredient succinylcholine without realising it: it is a standard component of the induction of anaesthesia. As the only depolarising muscle relaxant used in human medicine, succinylcholine causes a brief, complete paralysis of the muscles \u2014 and comes with a clearly defined profile of side effects. As there is no specific antidote for this active ingredient, it is worth being aware of its risks.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach.png\" alt=\"Schematic overview of the side effects of succinylcholine by organ system: muscles, heart, eyes\" class=\"wp-image-486\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach-900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach-300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach-768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach-1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach-18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_01-schematische-bersicht-der-succinylcholin-nebenwirkungen-nach-40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"wie-funktioniert-succinylcholin-wirkmechanismus-und-pharmakokinetik\">How does succinylcholine work? Mechanism of action and pharmacokinetics<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Succinylcholine binds to nicotinic acetylcholine receptors on the motor end-plate<\/li>\n\n\n\n<li>Onset of action: 40\u201360 seconds after intravenous injection<\/li>\n\n\n\n<li>Duration of action: 4\u20136 minutes under normal conditions<\/li>\n\n\n\n<li>Metabolised by pseudocholinesterase in plasma; metabolite: succinylmonocholine<\/li>\n\n\n\n<li>Pharmacological antagonism is not possible<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Succinylcholine (suxamethonium) binds to nicotinic acetylcholine receptors on the motor end-plate of skeletal muscle. Acetylcholine is the natural neurotransmitter at this synapse. Succinylcholine mimics its effect but is not broken down by synaptic acetylcholinesterase. The membrane remains permanently depolarised. The muscle fibre is unable to generate any further action potentials and becomes flaccid.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This state persists until the plasma enzyme <strong>Pseudocholinesterase<\/strong> (also: butyrylcholine esterase) hydrolyses the active substance. The first breakdown product is succinylmonocholine. Succinylmonocholine binds only weakly to receptors before it breaks down further into succinic acid and choline. Under normal conditions, this breakdown occurs rapidly. Succinylcholine is therefore classified as an ultra-short-acting muscle relaxant.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"warum-succinylcholin-klinisch-unverzichtbar-bleibt\">Why succinylcholine remains clinically indispensable<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Succinylcholine is primarily used in rapid sequence induction (RSI). RSI refers to an emergency method of inducing anaesthesia that minimises the risk of aspiration in patients with a full stomach. Its rapid onset of action and short duration of action make succinylcholine the drug of choice for this procedure. If intubation is unsuccessful, the paralysis wears off quickly \u2014 allowing the patient to breathe spontaneously again. No non-depolarising muscle relaxant achieves its onset of action within 40\u201360 seconds as quickly as succinylcholine.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"pseudocholinesterase-mangel-wenn-die-wirkung-zu-lange-anhalt\">Pseudocholinesterase deficiency: when the effect lasts too long<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">In cases of genetic or acquired pseudocholinesterase deficiency, the duration of action is significantly prolonged. Typical causes of an acquired deficiency include liver disease, pregnancy, malnutrition or cholinesterase inhibitors. Patients with a severe genetic defect may experience respiratory failure for hours following a standard dose. Mechanical ventilation is then absolutely essential. According to the prescribing information for Succinylcholine 2 % Inresa, a medical history regarding the risk of cholinesterase deficiency must therefore be taken prior to administration.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase.png\" alt=\"Diagram: Breakdown of succinylcholine by pseudocholinesterase in plasma\" class=\"wp-image-500\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase-900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase-300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase-768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase-1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase-18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_02-diagramm-abbau-von-succinylcholin-durch-pseudocholinesterase-40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"succinylcholin-nebenwirkungen-ubersicht-nach-organsystemen\">Succinylcholine side effects: an overview by organ system<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Fasciculations: uncontrolled muscle twitches preceding the onset of paralysis (very common, &gt;1\/10)<\/li>\n\n\n\n<li>Post-operative myalgia: muscle pain 12\u201324 hours after surgery (very common, &gt;1 in 10)<\/li>\n\n\n\n<li>Hyperkalaemia: increased potassium levels with a risk of cardiac arrhythmia (occasional, 1\/100\u20131\/10)<\/li>\n\n\n\n<li>Cardiac arrhythmias: bradycardia or tachycardia caused by vagal stimulation (occasionally)<\/li>\n\n\n\n<li>Increase in intraocular pressure: a critical factor in glaucoma and eye injuries (a well-known effect)<\/li>\n\n\n\n<li>Malignant hyperthermia: life-threatening muscle rigidity and fever (rare, <1>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The side effects of succinylcholine can be categorised according to the organ systems affected. This categorisation helps the anaesthesia team to identify high-risk patients specifically. The most important categories are explained individually below.<\/p>\n\n\n\n<svg aria-label=\"\u00dcbersicht der Succinylcholin-Nebenwirkungen nach Organsystemen\" role=\"img\" style=\"width:100%;max-width:800px;display:block;\" viewbox=\"0 0 800 420\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n<title>Side effects of succinylcholine by organ system<\/title>\n<desc>Infographic: Six organ systems and the associated side effects of succinylcholine, as at July 2026.<\/desc>\n<rect fill=\"var(--surface, #f9fafb)\" height=\"420\" rx=\"8\" stroke=\"var(--border, #e4e4e4)\" stroke-width=\"1\" width=\"800\"><\/rect>\n<text fill=\"var(--heading-color, #333333)\" font-family=\"'Roboto Slab', serif\" font-size=\"17\" font-weight=\"600\" text-anchor=\"middle\" x=\"400\" y=\"36\">Succinylcholine: side effects by organ system<\/text>\n<line stroke=\"var(--border, #e4e4e4)\" stroke-width=\"1\" x1=\"60\" x2=\"740\" y1=\"50\" y2=\"50\"><\/line>\n<rect fill=\"#ffffff\" height=\"100\" rx=\"6\" stroke=\"#f14d97\" stroke-width=\"1.5\" width=\"224\" x=\"30\" y=\"65\"><\/rect>\n<rect fill=\"#f14d97\" height=\"28\" rx=\"6\" width=\"224\" x=\"30\" y=\"65\"><\/rect>\n<rect fill=\"#f14d97\" height=\"14\" rx=\"0\" width=\"224\" x=\"30\" y=\"79\"><\/rect>\n<text fill=\"#ffffff\" font-family=\"'Roboto Slab', serif\" font-size=\"13\" font-weight=\"600\" x=\"42\" y=\"84\">Muscles<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"42\" y=\"111\">Fasciculations preceding paralysis\u2014<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"42\" y=\"126\">onset; post-operative myalgia<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"42\" y=\"141\">12\u201324 hours after surgery (very common)<\/text>\n<rect fill=\"#ffffff\" height=\"100\" rx=\"6\" stroke=\"#d63f84\" stroke-width=\"1.5\" width=\"224\" x=\"288\" y=\"65\"><\/rect>\n<rect fill=\"#d63f84\" height=\"28\" rx=\"6\" width=\"224\" x=\"288\" y=\"65\"><\/rect>\n<rect fill=\"#d63f84\" height=\"14\" rx=\"0\" width=\"224\" x=\"288\" y=\"79\"><\/rect>\n<text fill=\"#ffffff\" font-family=\"'Roboto Slab', serif\" font-size=\"13\" font-weight=\"600\" x=\"300\" y=\"84\">Cardiovascular<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"300\" y=\"111\">Bradycardia, tachycardia;<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"300\" y=\"126\">Cardiac arrhythmias caused by<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"300\" y=\"141\">Vagal stimulation is possible<\/text>\n<rect fill=\"#ffffff\" height=\"100\" rx=\"6\" stroke=\"#cc3578\" stroke-width=\"1.5\" width=\"224\" x=\"546\" y=\"65\"><\/rect>\n<rect fill=\"#cc3578\" height=\"28\" rx=\"6\" width=\"224\" x=\"546\" y=\"65\"><\/rect>\n<rect fill=\"#cc3578\" height=\"14\" rx=\"0\" width=\"224\" x=\"546\" y=\"79\"><\/rect>\n<text fill=\"#ffffff\" font-family=\"'Roboto Slab', serif\" font-size=\"13\" font-weight=\"600\" x=\"558\" y=\"84\">Metabolism \/ Potassium<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"558\" y=\"111\">Hyperkalaemia caused by potassium-<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"558\" y=\"126\">release; risk associated with kidney-<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"558\" y=\"141\">failure and burns<\/text>\n<rect fill=\"#ffffff\" height=\"100\" rx=\"6\" stroke=\"#a8003c\" stroke-width=\"1.5\" width=\"224\" x=\"30\" y=\"190\"><\/rect>\n<rect fill=\"#a8003c\" height=\"28\" rx=\"6\" width=\"224\" x=\"30\" y=\"190\"><\/rect>\n<rect fill=\"#a8003c\" height=\"14\" rx=\"0\" width=\"224\" x=\"30\" y=\"204\"><\/rect>\n<text fill=\"#ffffff\" font-family=\"'Roboto Slab', serif\" font-size=\"13\" font-weight=\"600\" x=\"42\" y=\"209\">Malignant hyperthermia<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"42\" y=\"236\">Rare (<1>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"42\" y=\"251\">threatening reaction;<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"42\" y=\"266\">Treatment: Dantrolene<\/text>\n<rect fill=\"#ffffff\" height=\"100\" rx=\"6\" stroke=\"#f14d97\" stroke-width=\"1.5\" width=\"224\" x=\"288\" y=\"190\"><\/rect>\n<rect fill=\"#f14d97\" height=\"28\" rx=\"6\" width=\"224\" x=\"288\" y=\"190\"><\/rect>\n<rect fill=\"#f14d97\" height=\"14\" rx=\"0\" width=\"224\" x=\"288\" y=\"204\"><\/rect>\n<text fill=\"#ffffff\" font-family=\"'Roboto Slab', serif\" font-size=\"13\" font-weight=\"600\" x=\"300\" y=\"209\">Eyes<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"300\" y=\"236\">Increase in intraocular pressure<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"300\" y=\"251\">intraocular pressure (IOP); contraindicated<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"300\" y=\"266\">in the case of penetrating eye injuries<\/text>\n<rect fill=\"#ffffff\" height=\"100\" rx=\"6\" stroke=\"#d63f84\" stroke-width=\"1.5\" width=\"224\" x=\"546\" y=\"190\"><\/rect>\n<rect fill=\"#d63f84\" height=\"28\" rx=\"6\" width=\"224\" x=\"546\" y=\"190\"><\/rect>\n<rect fill=\"#d63f84\" height=\"14\" rx=\"0\" width=\"224\" x=\"546\" y=\"204\"><\/rect>\n<text fill=\"#ffffff\" font-family=\"'Roboto Slab', serif\" font-size=\"13\" font-weight=\"600\" x=\"558\" y=\"209\">Immune response<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"558\" y=\"236\">Anaphylaxis (rare);<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"558\" y=\"251\">Histamine release;<\/text>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11.5\" x=\"558\" y=\"266\">allergic reactions are possible<\/text>\n<rect fill=\"#fff0f7\" height=\"42\" rx=\"6\" stroke=\"#f14d97\" stroke-width=\"1\" width=\"740\" x=\"30\" y=\"315\"><\/rect>\n<text fill=\"#a8003c\" font-family=\"'Montserrat', sans-serif\" font-size=\"11\" font-weight=\"700\" x=\"46\" y=\"333\">Frequencies:<\/text>\n<rect fill=\"#f14d97\" height=\"10\" rx=\"2\" width=\"10\" x=\"148\" y=\"321\"><\/rect>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11\" x=\"162\" y=\"332\">Very common (&gt;1 in 10): fasciculations, myalgia<\/text>\n<rect fill=\"#d63f84\" height=\"10\" rx=\"2\" width=\"10\" x=\"370\" y=\"321\"><\/rect>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11\" x=\"384\" y=\"332\">Occasionally (1\/100\u20131\/10): cardiac arrhythmias, hyperkalaemia<\/text>\n<rect fill=\"#a8003c\" height=\"10\" rx=\"2\" width=\"10\" x=\"148\" y=\"339\"><\/rect>\n<text fill=\"#333333\" font-family=\"'Montserrat', sans-serif\" font-size=\"11\" x=\"162\" y=\"350\">Rare (<1>\n<text fill=\"#888888\" font-family=\"'Montserrat', sans-serif\" font-size=\"10.5\" text-anchor=\"middle\" x=\"400\" y=\"400\">Source: Specialist information on succinylcholine, standard clinical guidelines for anaesthesiology | Last updated: July 2026 | 4beauty.com<\/text>\n<\/svg>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Side effects of succinylcholine by organ system, ranging from common fasciculations to the rare condition of malignant hyperthermia. As at July 2026.<\/em><\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Organ system<\/th><th>Side effect<\/th><th>Prevalence \/ Risk factor<\/th><\/tr><\/thead><tbody><tr><td>Skeletal muscles<\/td><td>Fasciculations, post-operative myalgia<\/td><td>Very common (&gt;1 in 10); particularly in muscular patients<\/td><\/tr><tr><td>Electrolytes \/ Heart<\/td><td>Hyperkalaemia, cardiac arrhythmias<\/td><td>Occasional (1\/100\u20131\/10); dangerous in cases of burns, renal insufficiency or denervation<\/td><\/tr><tr><td>Cardiovascular<\/td><td>Bradycardia, tachycardia<\/td><td>Occasionally; particularly after repeat doses<\/td><\/tr><tr><td>Eyes<\/td><td>Increase in intraocular pressure<\/td><td>A well-known effect; of particular concern in cases of glaucoma and penetrating eye injuries<\/td><\/tr><tr><td>Muscle metabolism<\/td><td>Malignant hyperthermia<\/td><td>Rare (<1><\/tr><tr><td>Immune system<\/td><td>Anaphylaxis \/ allergic reaction<\/td><td>Rare; in cases of known hypersensitivity<\/td><\/tr><tr><td>Gastrointestinal tract<\/td><td>Increased intragastric pressure<\/td><td>Due to fasciculations of the abdominal wall muscles<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"faszikulationen-und-postoperative-myalgien\">Fasciculations and post-operative myalgia<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Fasciculations are caused by the simultaneous depolarisation of all muscle fibres (very common, &gt;1\/10)<\/li>\n\n\n\n<li>Fasciculations last a few seconds; the patient is not consciously aware of them<\/li>\n\n\n\n<li>Muscle pain occurs 12\u201324 hours after surgery and subsides after 1\u20132 days<\/li>\n\n\n\n<li>Young, physically active patients are more severely affected than older ones<\/li>\n\n\n\n<li>Precurarisation with a non-depolarising muscle relaxant can reduce the intensity<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Fasciculations<\/strong> are brief, uncontrolled muscle twitches. Succinylcholine activates all nicotinic acetylcholine receptors simultaneously. This triggers a synchronous contraction of all muscle fibres. These twitches are visible on the torso, arms and legs. For patients planning cosmetic surgery, this means in practical terms that the twitches are not a sign of a complication, but an expected effect of the anaesthetic.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Fasciculations become problematic because they cause micromechanical damage to the muscle fibres. The effect is similar to a short, intense muscle workout. This results in post-operative myalgia.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"postoperative-myalgien-wer-ist-starker-betroffen\">Post-operative myalgia: who is most affected?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Post-operative myalgia following succinylcholine manifests as a dull muscle ache. Patients describe it as muscle soreness. The symptoms begin 12\u201324 hours after the operation. They subside after 1\u20132 days. Young, physically fit patients experience more severe myalgia than older patients or those with less muscle strength \u2014 because their fasciculations are more intense and cause more micro-injuries.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">To reduce the effects, the anaesthetic uses a so-called <strong>Pre-curation<\/strong> . A subparalytic dose of a non-depolarising muscle relaxant is administered a few minutes before succinylcholine. This occupies some of the acetylcholine receptors and reduces the intensity of fasciculations. However, this measure does not provide complete protection.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"hyperkaliamie-kaliumanstieg-als-herzrisiko\">Hyperkalaemia: elevated potassium levels as a cardiac risk factor<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Depolarisation releases potassium from muscle cells into the blood<\/li>\n\n\n\n<li>Normal increase: approx. 0.5 mmol\/l \u2014 clinically insignificant in healthy patients<\/li>\n\n\n\n<li>Patients at risk may develop potassium levels above 6.5 mmol\/l \u2014 which carries a risk of cardiac arrhythmia<\/li>\n\n\n\n<li>Main risk groups: burn victims, patients with renal failure, patients with denervation syndromes, immobilised patients<\/li>\n\n\n\n<li>Ventricular fibrillation may occur at levels above 7.0 mmol\/l<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Hyperkalaemia<\/strong> This is caused by succinylcholine, as the depolarisation of the muscle fibres releases potassium ions from inside the cells into the bloodstream. In healthy patients, the potassium level rises by approximately 0.5 mmol\/l. This level does not place a strain on the body.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The situation is different for patients with impaired muscle membrane function or pre-existing hyperkalaemia. According to the product information for Succinylcholine 2 % Inresa, the high-risk groups include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Patients with extensive burns (from the second week after the incident)<\/li>\n\n\n\n<li>Patients with chronic renal failure and pre-existing elevated potassium levels<\/li>\n\n\n\n<li>Patients with acute or chronic denervation syndromes (e.g. following spinal cord injuries, in cases of severe polyneuropathies)<\/li>\n\n\n\n<li>Patients following prolonged immobilisation or intensive care<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Potassium levels above 6.5 mmol\/l lead to serious cardiac arrhythmias. Levels above 7.0 mmol\/l can trigger ventricular fibrillation and cardiac arrest. For this reason, a history of hyperkalaemia is considered a relative contraindication. The anaesthesia team will then preferentially choose rocuronium.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"maligne-hyperthermie-seltene-notfallkomplikation\">Malignant hyperthermia: a rare emergency complication<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Malignant hyperthermia is a genetically determined reaction to trigger factors (rare, <1>\n\n\n\n<li>Succinylcholine is a known trigger, alongside halogenated inhalation anaesthetics<\/li>\n\n\n\n<li>Symptoms: muscle rigidity, body temperature above 40 \u00b0C, acidosis, tachycardia<\/li>\n\n\n\n<li>Treatment: immediate discontinuation of the trigger, intravenous dantrolene, cooling, correction of acidosis<\/li>\n\n\n\n<li>Absolute contraindication in cases of known predisposition or a positive family history<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The <strong>malignant hyperthermia<\/strong> (MH) is a rare, potentially fatal pharmacogenetic disorder affecting the skeletal muscles. Succinylcholine and halogenated inhalation anaesthetics such as sevoflurane or isoflurane trigger it in genetically predisposed patients. The mechanism: a defect in the ryanodine receptor (RYR1) leads to uncontrolled calcium release from the sarcoplasmic reticulum of the muscle fibres.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The consequences of this calcium overload are persistent muscle rigidity, an extreme increase in metabolic rate and a rapid rise in temperature to over 40 \u00b0C, sometimes as high as 44 \u00b0C. At the same time, severe metabolic acidosis develops. The heart responds with tachycardia and arrhythmias.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"symptome-und-diagnose-der-malignen-hyperthermie\">Symptoms and diagnosis of malignant hyperthermia<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Early on, an increase in end-tidal CO\u2082 (ETCO\u2082) and tachycardia become apparent \u2014 both signs of increased metabolism. Shortly afterwards, muscle rigidity develops, recognisable by increased jaw stiffness (masseter spasm). Without immediate treatment, malignant hyperthermia is life-threatening. The diagnosis is made clinically. A confirmatory test (in vitro contracture test) is only possible postoperatively at specialised centres. In Germany, the German Society for Anaesthesiology and Intensive Care Medicine (DGAI) coordinates these MH reference centres.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"behandlung-dantrolen-als-spezifisches-antidot\">Treatment: Dantrolene as a specific antidote<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">As soon as malignant hyperthermia is detected, the following emergency measures must be taken:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Discontinue all triggering factors immediately (succinylcholine, halogenated anaesthetics)<\/li>\n\n\n\n<li>Switch to anaesthesia using non-triggering substances (e.g. total intravenous anaesthesia with propofol)<\/li>\n\n\n\n<li>Intravenous dantrolene as a specific antidote; dantrolene inhibits the release of calcium from the sarcoplasmic reticulum<\/li>\n\n\n\n<li>Physical cooling of the patient (ice packs, chilled infusions)<\/li>\n\n\n\n<li>Correction of acidosis and electrolyte imbalances<\/li>\n\n\n\n<li>Intensive care monitoring for at least 24 hours<\/li>\n<\/ol>\n\n\n\n<div class=\"wp-block-group is-style-boxed is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Important<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Succinylcholine is absolutely contraindicated in cases of known malignant hyperthermia or a positive family history. Patients with a known predisposition to MH should carry an emergency ID card and inform the anaesthesia team of this before any anaesthesia.<\/p>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"kardiovaskulare-effekte-bradykardie-und-herzrhythmusstorungen\">Cardiovascular effects: bradycardia and cardiac arrhythmias<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Succinylcholine stimulates not only nicotinic but also muscarinic acetylcholine receptors in the heart. This results in vagal stimulation, which manifests as <strong>Bradycardia<\/strong> This effect is particularly pronounced in children and following repeated administration. Paradoxically, tachycardia also occurs in adults when stimulation primarily involves the sympathetic ganglia.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">More serious cardiac arrhythmias result from the combination of vagal stimulation and hyperkalaemia. This combination is dangerous in patients with pre-existing conditions. ECG monitoring is therefore mandatory during the administration of succinylcholine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"anstieg-des-augeninnendrucks-risiko-bei-glaukom-und-offenen-augenverletzungen\">Increased intraocular pressure: a risk factor in glaucoma and open eye injuries<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Succinylcholine increases the following through fasciculations of the extraocular muscles and an increase in central venous pressure: <strong>intraocular pressure (IOP)<\/strong> Temporary. In most patients, this effect is clinically insignificant. However, in patients with glaucoma or penetrating eye injuries, increased IOP can cause vitreous humour to be forced out through the wound \u2014 with the risk of permanent vision loss.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Succinylcholine is therefore relatively contraindicated in cases of penetrating eye injuries. The decision rests with the experienced anaesthetist, who must weigh up the risk of aspiration (an indication for RSI) against the risk to the eye.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"kontraindikationen-wann-ist-succinylcholin-ungeeignet\">Contraindications: When is succinylcholine unsuitable?<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Absolute contraindications completely preclude administration<\/li>\n\n\n\n<li>Relative contraindications require a careful assessment of the benefits and risks<\/li>\n\n\n\n<li>According to the product information, succinylcholine must only be administered by experienced anaesthetists<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Succinylcholine is not suitable for every patient. The prescribing information for Succinylcholine 2 % Inresa sets out clear absolute and relative contraindications:<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au.png\" alt=\"Before an operation, the anaesthetist checks the patient\u2019s medical records for any contraindications on the monitoring screen.\" class=\"wp-image-522\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au-900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au-300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au-768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au-1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au-18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_03-an-sthesistin-pr-ft-vor-einer-operation-die-patientenakte-au-40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Absolute contraindication:<\/strong> a history of malignant hyperthermia or a family history of the condition<\/li>\n\n\n\n<li><strong>Absolute contraindication:<\/strong> lack of facilities for artificial ventilation<\/li>\n\n\n\n<li><strong>Relative contraindication:<\/strong> Pseudocholinesterase deficiency (prolonged neuromuscular blockade)<\/li>\n\n\n\n<li><strong>Relative contraindication:<\/strong> Risk of hyperkalaemia (burns from the second week onwards, renal insufficiency, denervation syndromes)<\/li>\n\n\n\n<li><strong>Relative contraindication:<\/strong> Glaucoma or penetrating eye injuries<\/li>\n\n\n\n<li><strong>Relative contraindication:<\/strong> neuromuscular disorders (e.g. muscular dystrophies, myasthenia gravis)<\/li>\n\n\n\n<li><strong>Relative contraindication:<\/strong> known hypersensitivity to other muscle relaxants<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">According to the product information, succinylcholine must only be administered by doctors who are proficient in intubation, artificial ventilation and resuscitation procedures. Neuromuscular function should be monitored intraoperatively using a <strong>Nerve stimulators<\/strong> be monitored to prevent overdoses and underdoses.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"succinylcholin-vs-rocuronium-vergleich-und-entscheidungskriterien\">Succinylcholine vs. Rocuronium: Comparison and Decision-Making Criteria<\/h2>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-apricot-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Key points at a glance<\/strong><\/p>\n\n<ul class=\"wp-block-list\">\n<li>Rocuronium is a non-depolarising muscle relaxant that does not carry a risk of hyperkalaemia<\/li>\n\n\n\n<li>Rocuronium can be completely antagonised by sugammadex; succinylcholine cannot<\/li>\n\n\n\n<li>At a high dose (1.2 mg\/kg), rocuronium takes effect with comparable speed<\/li>\n\n\n\n<li>The choice depends on the patient\u2019s individual risk profile<\/li>\n<\/ul>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Succinylcholine and rocuronium are the two muscle relaxants primarily used for RSI. Both have different profiles of side effects. The following table summarises the key differences:<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem-.png\" alt=\"Two loaded syringes placed side by side on a sterile tray symbolise the choice between different muscle relaxants.\" class=\"wp-image-557\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem-.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem--900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem--300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem--768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem--1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem--18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_04-zwei-aufgezogene-injektionsspritzen-nebeneinander-auf-einem--40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><thead><tr><th>Characteristic<\/th><th>Succinylcholine<\/th><th>Rocuronium<\/th><\/tr><\/thead><tbody><tr><td>Class of active substances<\/td><td>Depolarising muscle relaxant<\/td><td>Non-depolarising muscle relaxant<\/td><\/tr><tr><td>Onset of action (i.v.)<\/td><td>40\u201360 seconds<\/td><td>60\u201390 seconds (at 1.2 mg\/kg: approx. 60 sec.)<\/td><\/tr><tr><td>Duration of action<\/td><td>4\u20136 minutes<\/td><td>30\u201360 minutes (depending on the dose)<\/td><\/tr><tr><td>Can be antagonised<\/td><td>No<\/td><td>Yes, completely with sugammadex<\/td><\/tr><tr><td>Risk of hyperkalaemia<\/td><td>Yes<\/td><td>No<\/td><\/tr><tr><td>Malignant hyperthermia<\/td><td>Trigger<\/td><td>No trigger<\/td><\/tr><tr><td>Fasciculations<\/td><td>Yes<\/td><td>No<\/td><\/tr><tr><td>Benefit for RSI<\/td><td>Shortest duration of action in the event of intubation failure<\/td><td>Reversible with sugammadex<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">The availability of <strong>Sugammadex<\/strong>, a cyclodextrin derivative that selectively binds to and neutralises rocuronium, has transformed the clinical debate. Should a \u201eCannot Intubate, Cannot Oxygenate\u201c situation arise, sugammadex completely reverses the neuromuscular blockade in approximately 3 minutes. This represents a significant safety advantage over succinylcholine, which cannot be antagonised.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nevertheless, succinylcholine remains the preferred choice in certain situations: in patients with no contraindications, when the shortest possible duration of action is crucial, or when sugammadex is not available.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"narkosekomplikationen-bei-schonheitsoperationen-finanzielle-absicherung\">Anaesthetic complications in cosmetic surgery: financial protection<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Cosmetic surgery such as liposuction, tummy tucks or rhinoplasty is almost always carried out under general anaesthesia. This involves the use of muscle relaxants such as succinylcholine. Anaesthetic complications are rare, but can occur \u2014 through no fault of either the doctor or the patient.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr.png\" alt=\"A person calmly signs an insurance policy to cover themselves against anaesthetic complications during a planned operation.\" class=\"wp-image-562\" srcset=\"https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr.png 1536w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr-900x600.png 900w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr-300x200.png 300w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr-768x512.png 768w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr-1024x683.png 1024w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr-18x12.png 18w, https:\/\/4beauty.de\/wp-content\/uploads\/2026\/08\/2026-07_05-eine-person-unterzeichnet-entspannt-einen-versicherungsvertr-40x27.png 40w\" sizes=\"auto, (max-width: 1536px) 100vw, 1536px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">If a complication arises following a cosmetic procedure, statutory health insurance funds will only cover some of the resulting costs, if any at all. Treatments, revision surgery and hospital stays must then be paid for privately. Such costs can quickly mount up to substantial sums.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One <a href=\"https:\/\/4beauty.de\/en\/after-care-insurance\/\">Consequential Costs Insurance<\/a> covers you in precisely this situation: it covers medically necessary follow-up treatment and operations resulting from the insured procedure \u2014 transparently and without any red tape. You can find further information on the terms and conditions and the procedures covered in our <a href=\"https:\/\/4beauty.de\/en\/after-care-insurance\/questions-and-answers\/\">FAQ section<\/a>.<\/p>\n\n\n\n<div class=\"wp-block-group is-style-boxed has-anchor-light-background-color has-background is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"wp-block-paragraph\"><strong>Note<\/strong><\/p>\n\n<p class=\"wp-block-paragraph\">Complications arising from anaesthetics are covered under insurance, even if no negligence can be proven on the part of either the patient or the doctor. Insurance against consequential costs provides you with financial security, allowing you to focus on your recovery.<\/p>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"haufig-gestellte-fragen-zu-succinylcholin-nebenwirkungen\">Frequently Asked Questions about the side effects of succinylcholine<\/h2>\n\n\n\n<div data-wp-context=\"{ &quot;autoclose&quot;: false, &quot;accordionItems&quot;: [] }\" data-wp-interactive=\"core\/accordion\" role=\"group\" class=\"wp-block-accordion is-layout-flow wp-block-accordion-is-layout-flow\">\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-1&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-1-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-1\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">What are the most common side effects of succinylcholine?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-1\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-1-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">According to the MedDRA classification, succinylcholine side effects occur very commonly (&gt;1\/10): fasciculations are uncontrolled muscle twitches that occur immediately before the onset of paralysis. Post-operative myalgia manifests as muscle pain that begins 12\u201324 hours after the procedure and subsides after 1\u20132 days. In high-risk patients, hyperkalaemia and cardiac arrhythmias may also occur.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-2&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-2-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-2\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">When is succinylcholine contraindicated?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-2\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-2-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Succinylcholine must not be used in cases of known or familial malignant hyperthermia. It is also absolutely contraindicated if mechanical ventilation is not possible. Particular caution is required in cases of pseudocholinesterase deficiency, renal insufficiency, extensive burns, glaucoma or neuromuscular disorders. In such cases, the anaesthesia team should consider using rocuronium with sugammadex for antagonism.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-3&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-3-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-3\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">How is malignant hyperthermia treated with succinylcholine?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-3\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-3-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Succinylcholine must be discontinued immediately in the event of malignant hyperthermia. Anaesthesia is switched to non-triggering agents. Dantrolene \u2014 the specific antidote \u2014 is administered intravenously; dantrolene inhibits the uncontrolled release of calcium into the muscle cells. In addition, the patient is physically cooled, acidosis is corrected and the patient is monitored in an intensive care unit for at least 24 hours.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-4&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-4-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-4\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">What is the difference between succinylcholine and rocuronium?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-4\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-4-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">Succinylcholine is a depolarising muscle relaxant. Onset of action: 40\u201360 seconds; duration of action: 4\u20136 minutes; cannot be antagonised. Rocuronium is non-depolarising, has a longer duration of action and can be completely reversed with sugammadex. Rocuronium does not cause fasciculations and carries no risk of hyperkalaemia. The choice between the two depends on the patient\u2019s individual risk profile.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div data-wp-class--is-open=\"state.isOpen\" data-wp-context=\"{ &quot;id&quot;: &quot;accordion-item-5&quot;, &quot;openByDefault&quot;: false }\" data-wp-init=\"callbacks.initAccordionItems\" data-wp-on-window--hashchange=\"callbacks.hashChange\" class=\"wp-block-accordion-item is-layout-flow wp-block-accordion-item-is-layout-flow\">\n<h3 class=\"wp-block-accordion-heading\"><button aria-expanded=\"false\" aria-controls=\"accordion-item-5-panel\" data-wp-bind--aria-expanded=\"state.isOpen\" data-wp-on--click=\"actions.toggle\" id=\"accordion-item-5\" type=\"button\" class=\"wp-block-accordion-heading__toggle\"><span class=\"wp-block-accordion-heading__toggle-title\">Can succinylcholine-induced myalgia be prevented?<\/span><span class=\"wp-block-accordion-heading__toggle-icon\" aria-hidden=\"true\">+<\/span><\/button><\/h3>\n\n\n\n<div aria-labelledby=\"accordion-item-5\" data-wp-bind--hidden=\"state.isHidden\" data-wp-on--beforematch=\"actions.handleBeforeMatch\" id=\"accordion-item-5-panel\" role=\"region\" class=\"wp-block-accordion-panel is-layout-flow wp-block-accordion-panel-is-layout-flow\">\n<p class=\"wp-block-paragraph\">It is not possible to completely prevent post-operative myalgia. Pre-curariation \u2014 the administration of a non-depolarising muscle relaxant at a sub-paralytic dose \u2014 reduces the intensity of fasciculations and thus also myalgia. Alternatively, rocuronium may be used if myalgia would be particularly distressing for the patient.<\/p>\n<\/div>\n<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Succinylcholine is the only depolarising muscle relaxant; its side effects include fasciculations, hyperkalaemia and, rarely, malignant hyperthermia.<\/p>","protected":false},"template":"","class_list":["post-752","glossary","type-glossary","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/glossary\/752","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/glossary"}],"about":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/types\/glossary"}],"wp:attachment":[{"href":"https:\/\/4beauty.de\/en\/wp-json\/wp\/v2\/media?parent=752"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}