A 30 yr old man with paraplegia, the muscle relaxant should be avoided for tracheal intubation will be: (A) Suxamethonium, (B) Vecuronium, (C) Rocuronium, (D) Mivacurium
Answer is A. Succinylcholine can cause hyperkalemia in paraplegic patients due to proliferation of extrajunctional receptor. Conditions causing susceptibility to succinylcholine-induced hyperkalemia in an order. Myopathies (eg, Duchenne's dystrophy) Spinal cord injury Encephalitis Stroke Guillain-Barre syndrome Severe Parkinson's disease Burn injury Massive trauma Severe intraabdominal infection Tetanus Hence the use of succinyl choline is avoided in all the above conditions.