In Reply:-The debate as to when it is safe or unsafe to administer succinylcholine to a patient with burns has existed since the problem with hyperkalemia was first identified. There is a paucity of data derived from studies on patients, and it is always dangerous to make broad clinical recommendations based on data from animal studies.
We appreciate Dr. Gronert's letter, which challenges our conservative admonition that succinylcholine is only safe within 24 h after a burn injury. He states that succinylcholine is safe for up to 6 days after a burn injury. Dr. Gronert is an expert in muscle relaxants and his opinions must be respected.
However, experts often differ in their opinions. Perhaps that is true in this circumstance. Until more definitive information becomes available, we will likely continue the more conservative approach in our practice.
Neil MacLennan, M.D.
David M. Heimbach, M.D.
Bruce F. Cullen, M.D.
Departments of Anesthesiology and Surgery; University of Washington School of Medicine; Harborview Medical Center; Seattle, Washington 98104;firstname.lastname@example.org
(Accepted for publication February 25, 1999.)