All of the following concerning succinylcholine use in children are true EXCEPT:
A. Dysrrhythmias are more likely after a second dose of succinylcholine
B. Dysrrhythmias are more common after an intramuscular injection when compared to an intravascular injection
C. Ventricular ectopy and nodal rhythms are seen in up to 80% of children after succinylcholine administration
D. Atropine seems to lessen the bradyarrhythmias in all age groups
The answer is B. It is well known that in children, profound sustained sinus bradycardia ( < 60 beats/min) are often encountered after succinylcholine administration. Asystole occurs rarely but may be observed. Ventricular ectopy and nodal rhythms are seen in about 70-80% of children given an intravenous injection of succinylcholine. Arrhythmias are much less significant after an intramuscular injection of succinylcholine. This occurrence of arrhythmias is much more common and frequent after repeated dose of succinylcholine. Atropine appears to offer some protection against these bradyarrhythmias in children, but does not completely eliminate it. This may be due to other factors during induction and airway instrumentation.