Question:hard
The use of succinylcholine is NOT contraindicated in
The use of succinylcholine is NOT contraindicated in
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Tetanus, head injury, and stroke all carry a real hyperkalaemia or raised intracranial pressure risk with succinylcholine; hepatic failure only slows its breakdown and prolongs paralysis.
Updated On: Jul 8, 2026
- Tetanus
- Closed head injury
- Cerebral stroke
- Hepatic failure
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Separate the two ways succinylcholine can harm a patient.
One danger is a sudden rise in blood potassium from extra receptors on muscle. The other is a rise in intracranial pressure from the muscle fasciculations it causes. A safe answer here is a condition that triggers neither problem.
Step 2: Test tetanus against these dangers.
Prolonged spasm in tetanus leads muscle to sprout extra receptors across its whole surface, not just at the normal junction. Succinylcholine hitting all these receptors at once releases a large amount of potassium, so tetanus is dangerous with this drug.
Step 3: Test closed head injury and stroke.
In both, fasciculation driven jumps in cerebral blood flow can push an already strained intracranial pressure even higher, and stroke adds a further hyperkalaemia risk from the weak, disused limb. Both are treated as unsafe.
Step 4: Test hepatic failure on the same two dangers.
Liver failure lowers the pseudocholinesterase enzyme that clears succinylcholine from plasma, so paralysis simply lasts longer than usual. There is no extra receptor spread and no fasciculation related pressure spike here, so neither of the two real dangers applies.
Step 5: Conclude.
Only hepatic failure lacks both mechanisms of harm, so succinylcholine is not truly contraindicated there, only prolonged in effect.
\[ \boxed{\text{Hepatic failure}} \]
One danger is a sudden rise in blood potassium from extra receptors on muscle. The other is a rise in intracranial pressure from the muscle fasciculations it causes. A safe answer here is a condition that triggers neither problem.
Step 2: Test tetanus against these dangers.
Prolonged spasm in tetanus leads muscle to sprout extra receptors across its whole surface, not just at the normal junction. Succinylcholine hitting all these receptors at once releases a large amount of potassium, so tetanus is dangerous with this drug.
Step 3: Test closed head injury and stroke.
In both, fasciculation driven jumps in cerebral blood flow can push an already strained intracranial pressure even higher, and stroke adds a further hyperkalaemia risk from the weak, disused limb. Both are treated as unsafe.
Step 4: Test hepatic failure on the same two dangers.
Liver failure lowers the pseudocholinesterase enzyme that clears succinylcholine from plasma, so paralysis simply lasts longer than usual. There is no extra receptor spread and no fasciculation related pressure spike here, so neither of the two real dangers applies.
Step 5: Conclude.
Only hepatic failure lacks both mechanisms of harm, so succinylcholine is not truly contraindicated there, only prolonged in effect.
\[ \boxed{\text{Hepatic failure}} \]
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