ROUTINE SUXAMETHONIUM IN CHILDREN - A REGIONAL SURVEY OF CURRENT USAGE

This survey aimed to assess the extent and pattern of nse of suxametho nium for elective tracheal intubation in children and the occurrence o f major complications. A postal questionnaire was sent to 280 consulta nt anaesthetists and senior registrars in the West Midlands Region, Of the 180 replies received, 84% of respondents use suxamethonium routin ely. Usage,vas more common amongst those more recently trained (all an aesthetists with less than 10 years experience reported using suxameth onium for routine intubation compared with 81% of those with over 20 y ears experience). Reported side effects directly attributable to suxam ethonium were common, the most freqent being cardiac arrhythmias (espe cially bradycardia) following the first dose (24% respondents) oi the second dose (43%), and prolonged apnoea (36% of respondents). There we re 13 reported cardiac arrests (requiring external cardiac massage), t hree of which were associated with repeat dosing and one with undiagno sed. Duchenne muscular dystrophy. Three cases of documented hyperkalae mia did not lead to cardiac arrest. There were two deaths, neither of which could be solely attributed to the use of suxamethonium. We concl ude that suxamethonium remains popular in paediatric practice and that minor side effects are common and usually preventable. Life-threateni ng reactions are rare and until a truly comparable alternative is prod uced this drug will continue to be toed in children.