Question

The registered nurse anesthetist has administered a small dose of nondepolarizing neuromuscular junction (nmj) blocker before administering succinylcholine. what outcome most clearly indicates therapeutic effect of this action?

Answer 1

Administering a small dose of nondepolarizing NMJ blocker prior to succinylcholine introduction has the immediate effect of lessening the potency of succinylcholine and requiring a higher dosage to have the desired effect. This technique, called precurarization, is used to lessen post-treatment muscle pain that is a common after effect of succinylcholine, due to the muscular fasciculations (muscle twitches) that occur during the Phase 1 block. This muscle pain occurs most frequently in those that may have a larger muscle mass (i.e. younger and healthier adults) and shows up in atypical places, such as the diaphragm, intercostal muscles and between the scapulae.