Succinylcholine (Sch) has been considered to be the neuromuscular blockade (NMB) of choice in clinical anesthesia due to its rapid onset and short duration of action. Despite these clinical advantages, the use of Sch has decreased recently on account of its potentially fatal adverse effects such as cardiac arrest and malignant hyperthermia. The aim of this report was to analyze the frequency and the indications of Sch as well as to discover an alternative to decreasing the frequency of Sch use.

The medical records of a total of 33,972 cases under general anesthesia were collected retrospectively, and the frequency of Sch use and the reason for choosing Sch was analyzed. The side effects and other complications of Sch were also analyzed.

A muscle relaxant was administered in 32,724 cases (96.3%) out of 33,972 cases, and Sch was used in 647 of these cases (1.9%). The reasons for choosing Sch were the rapid sequence induction (291 cases), short operation time (220 cases), recent food intake (51 cases), habitual use (78 cases) and reintubation (7 cases). There were 211 cases of the single administration of Sch and 13 cases in whom Sch was injected repeatedly. A non-depolarizing muscle relaxant (NDMR) was used after Sch administration in 423 cases. Precurarization was carried out in 434 cases (67%) and no severe complications were observed.

The frequency of using Sch use can be decreased by reducing the habitual use and choosing the intubating dose of the intermediate acting NDMR as an alternative.