Procaine type local anesthetics are also metabolized by plasma cholinesterases, and will competitively inhibit the metabolism of succinylcholine, resulting in a prolonged duration of action. Decamethonium is excreted directly by the kidney. Because of their ionized structure, they are poorly absorbed orally, and are given i.v. G. Toxicity 1. Prolonged apnea 2.
Malignant hyperthermia can occur when patients are receiving halothane and succinylcholine.
It is one of the main causes of death due to anesthesia. In vitro tests are available to evaluate susceptibility to malignant hyperthermia and results in a prediction of susceptible, normal, or equivocal. In these cases, competitive neuromuscular blockers should be used. Mainly as adjuvants to surgical anesthesia to cause muscle relaxation. In orthopedics to facilitate correction of dislocations and alignment of fractures.