Question

I am a breastfeeding mother and i want to know if it is safe to use Succcinylcholine? Is Succcinylcholine safe for nursing mother and child? Does Succcinylcholine extracts into breast milk? Does Succcinylcholine has any long term or short term side effects on infants? Can Succcinylcholine influence milk supply or can Succcinylcholine decrease milk supply in lactating mothers?

Succcinylcholine lactation summary

Succcinylcholine is safe in breastfeeding
  • DrLact safety Score for Succcinylcholine is 1 out of 8 which is considered Safe as per our analyses.
  • A safety Score of 1 indicates that usage of Succcinylcholine is mostly safe during lactation for breastfed baby.
  • Our study of different scientific research also indicates that Succcinylcholine does not cause any serious side effects in breastfeeding mothers.
  • Most of scientific studies and research papers declaring usage of Succcinylcholine safe in breastfeeding are based on normal dosage and may not hold true for higher dosage.
  • Score calculated using the DrLact safety Version 1.2 model, this score ranges from 0 to 8 and measures overall safety of drug in lactation. Scores are primarily calculated using publicly available case studies, research papers, other scientific journals and publically available data.

Answer by Dr. Ru: About Succcinylcholine usage in lactation

Muscle-relaxant agent with a peripheric depolarizing action that is used for rapid endotracheal intubation procedures, which also has a transient effect. At latest update, no relevant published data concerning excretion into breast milk were found. Because of a very rapid half-life elimination period (less than 1 minute), a significant excretion into breast milk is unlikely. Also, a low oral bioavailability renders the pass of this agent to the infant's plasma, highly unlikely. Succinylcholine should not prevent a mother from breast feeding her baby shortly after recovering from an anesthesia if she is in a good condition. List of Medicines (WHO-2002): compatible with Breastfeeding.

Answer by DrLact: About Succcinylcholine usage in lactation

No information is available on the use of succinylcholine during breastfeeding. Because it is rapidly eliminated and poorly absorbed orally, it is not likely to reach the bloodstream of the infant or cause any adverse effects in breastfed infants.[1][2] A general anesthetic regimen that included succinylcholine for cesarean section caused a delay in the time to the first breastfeeding, but the part that succinylcholine played in this difference in outcome in unknown.

Succcinylcholine Possible Effects in Breastfeeding

A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia's effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants. It is not known what part succinylcholine played in this difference in outcome.[3]
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