Indications: this is a depolarizing muscle-relaxant which is used for short surgical procedures especially in the abdominal region, reposition of fractures and dislocations, endoscopies; laryngo-broncho- and cystoscopies.

Cautions: liver dysfunction; patients with cardiac, respiratory or neuromuscular disease; raised intra-ocular pressure (avoid in penetrating eye injury); severe sepsis (risk of hyperkalaemia);

Contra-indications: family history of malignant hyperthermia, low plasma cholinesterase activity (including severe liver disease), hyperkalaemia; major trauma, severe burns, neurological disease involving acute wasting of major muscle, prolonged immobilisation—risk of hyperkalaemia, personal or family history of congenital myotonic disease, Duchenne muscular dystrophy.

Side Effects: postoperative muscle pain, myoglobinuria, myoglobinaemia; tachycardia, arrhythmias, cardiac arrest, hypertension, hypotension; bronchospasm, apnoea, prolonged respiratory depression, anaphylactic reactions; hyperkalaemia; hyperthermia; increased gastric pressure; rash, flushing.

Dose: by IV injection, 20-100 mg according to the patient's needs.

Child, initially 1-1.5 mg/kg, then l/3rd of the initial dose. By IV infusion as a 0.1% solution, 2.5 mg/minute (2-5 ml/minute).