琥珀膽鹼
Succinylcholine Chloride
Suxamethonium chloride
別名: Anectine · Quelicin · choline chloride succinate · succicurarium chloride · suxamethonii chloridum · suxametonklorid · suxamethonium chloride
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.07 mg/kg | IV | Single dose | — | 🌎 NA |
| Muscle relaxation | 0.22 mg/kg | IV | Single dose | — | 🌎 NA |
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.06 mg/kg | IV | Single dose | — | 🌎 NA |
| Muscle relaxation | 0.11 mg/kg | IV | Single dose | — | 🌎 NA |
爬蟲類
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| To relax an animal to allow intubation | 0.5-1 mg/kg | IM | Single dose | — | 🌎 NA |
- To relax an animal to allow intubation: Especially helpful with turtles and crocodilians.
馬
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Muscle relaxation | 0.088-0.11 mg/kg | IV, IM | Single dose | — | 🌎 NA |
- Muscle relaxation: See Precautions. ARCI UCGFS Class 2 Drug. 0.088 mg/kg IV may paralyze skeletal muscles without causing respiratory depression, but higher doses cause apnea.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
氯化琥珀膽鹼是一種超短效的去極化型骨骼肌鬆弛劑（麻痺劑）。
關鍵臨床要點：
- 無鎮痛或鎮靜作用： 琥珀膽鹼絕對不提供任何止痛或意識喪失的效果。病患完全清醒且能感覺疼痛，但全身癱瘓。必須始終與適當的鎮靜劑、麻醉劑和鎮痛劑併用。
- 需要呼吸器支持： 因為它會麻痺橫膈膜和肋間肌，在藥效消退前必須進行機械通氣。
- 臨床用途： 主要用於需要短期肌肉鬆弛的氣管插管（快速順序插管）、外科/診斷程序，或減少抽搐時的肌肉收縮。
- 物種差異： 雖然在人類和多數動物中作用時間極短（2-3分鐘），但狗會表現出特異性的延長作用時間（約20分鐘）。
- 現代應用： 在獸醫學中，其使用已很大程度上被副作用較少且可逆的非去極化型藥物（如阿曲庫銨、羅庫溴銨）所取代。
作用機制
Succinylcholine acts as a depolarizing neuromuscular blocker.
- Binding: It acts as a structural analog of acetylcholine (ACh) and binds to nicotinic acetylcholine receptors (nAChRs) at the motor endplate of the neuromuscular junction.
- Depolarization: Unlike ACh, which is instantly degraded by acetylcholinesterase, succinylcholine remains bound, causing prolonged depolarization of the muscle membrane. This initial depolarization manifests clinically as transient muscle twitches (fasciculations).
- Paralysis: Because the membrane cannot repolarize, it becomes unresponsive to subsequent ACh release → flaccid paralysis (Phase I block).
- Metabolism: The blockade persists until succinylcholine diffuses away from the receptor and is rapidly hydrolyzed by plasma pseudocholinesterase (butyrylcholinesterase) in the blood.
安全性與警告
禁忌症
- Severe liver disease
- Chronic anemias
- Chronic malnourishment
- Glaucoma or penetrating eye injuries
- Predisposition to malignant hyperthermia
- Increased CPK values with resultant myopathies
- Recent use of organophosphate agents
不良反應
- Muscle soreness
- Histamine release
- Malignant hyperthermia
- Excessive salivation
- Hyperkalemia
- Rash
- Myoglobinemia
- Myoglobinuria
- Bradycardia
- Tachycardia
- Hypertension
- Hypotension
- Arrhythmias
注意事項
CRITICAL WARNING: Succinylcholine has NO analgesic or anesthetic effects. It must be used with appropriate analgesic, sedative, and anesthetic agents. Mechanical ventilation is required.
- Hyperkalemia Risk: Use with extreme caution in patients with traumatic wounds, burns, preexisting hyperkalemia, or electrolyte imbalances, as fatal arrhythmias or cardiac arrest may occur due to sudden potassium efflux from muscle cells.
- Organ Dysfunction: Use with caution in patients with pulmonary, renal, cardiovascular, metabolic, or hepatic dysfunction.
- Equine Specifics (AAEP Recommendations): Inform owners it is a restraining agent, not an anesthetic. Do not use if the horse has received 'mycin' antibiotics, organophosphates, cholinesterase inhibitors, or procaine within 30 days. Do not use in debilitated/exhausted horses. Withhold food 4-6 hours prior. Be prepared to administer oxygen and artificial respiration. Have a handler prevent the horse from falling forward.
藥物相互作用
May increase succinylcholine's effects by causing electrolyte imbalances
Succinylcholine may cause a sudden outflux of potassium from muscle cells, causing arrhythmias in digitalized patients
Potential for increased incidences of bradycardia and sinus arrest
May increase succinylcholine's effects by causing electrolyte imbalances
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade
May increase or prolong neuromuscular blockade (Contraindicated)
監測
- Level of muscle relaxation
- Cardiac rate and rhythm (ECG)
- Respiratory depressant effect (Apnea)
- Oxygenation (Pulse oximetry) and Ventilation (Capnography)
- Body temperature (risk of malignant hyperthermia)
藥物動力學
半衰期
吸收
IV onset of action is usually within 30-60 seconds. IM onset is generally within 2-3 minutes.
分佈
Diffuses away from the motor end plate. Crosses the placenta in low concentrations.
代謝
Rapidly hydrolyzed by plasma pseudocholinesterases to succinylmonocholine (weak blocking activity) and choline.
排除
10% is excreted unchanged in the urine. Succinylmonocholine is partially excreted in the urine and may accumulate in renal impairment.
過量
Inadvertent overdoses, or standard doses in patients deficient in pseudocholinesterase, may result in prolonged apnea.
- Treatment: Mechanical ventilation with 100% O2 must be maintained until full spontaneous recovery occurs.
- Phase II Block: Repeated or prolonged high dosages may cause patients to convert from a depolarizing (Phase I) block to a non-depolarizing-like (Phase II) block.
可用產品
劑型
- Injection solution
- Powder for infusion
人用標示
- Succinylcholine Chloride Injection: 20 mg/mL in 10 mL vials and 5 mL syringes
- Succinylcholine Chloride Injection, Solution: 100 mg/mL in 5 mL & 10 mL vials
- Succinylcholine Chloride Powder for Infusion: 500 mg & 1 gram in vials
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Commercial injectable solutions should be stored refrigerated (2°-8°C). Multiple dose vials of Anectine are stable up to 2 weeks at room temperature. Powder forms are stable indefinitely unopened at room temperature. Reconstituted powder is stable for 4 weeks at 5°C or 1 week at room temperature, but use within 24 hours is recommended as it contains no preservatives.
飼主須知
本藥物僅限由受過訓練的獸醫專業人員在臨床環境中使用。
- 重要提示： 這是一種肌肉麻痺劑。它會停止肌肉運動，包括用於呼吸的肌肉，但它不提供任何止痛或鎮靜效果。
- 在給予此藥物之前，您的寵物將會接受其他藥物，以確保牠們完全熟睡且無痛覺。
- 因為它會停止呼吸肌肉的運作，獸醫團隊將會為您的寵物放置呼吸管，並使用呼吸器協助呼吸，直到藥效完全消退為止。
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠方最新藥品說明書。