The administration of succinylcholine to a paraplegic patient led to the appearance of dysrhythmias, conduction abnormalities and finally cardiac arrest. The most likely cause is –
**Core Concept**
Succinylcholine is a depolarizing neuromuscular blocking agent that can cause hyperkalemia, especially in patients with muscle damage, denervation, or burns. This hyperkalemia can lead to cardiac complications such as dysrhythmias and cardiac arrest.
**Why the Correct Answer is Right**
In paraplegic patients, the denervation of muscles leads to a shift from aerobic to anaerobic metabolism, causing an increase in potassium release from the muscles into the bloodstream. Succinylcholine's depolarizing action further exacerbates this potassium release, resulting in hyperkalemia. This hyperkalemia can affect the cardiac conduction system, leading to dysrhythmias and potentially cardiac arrest.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not provided.
* **Option B:** While muscle damage and burns can also cause hyperkalemia, they are not the most likely cause in a paraplegic patient receiving succinylcholine.
* **Option C:** Hypokalemia is not a likely cause of cardiac complications in this scenario.
**Clinical Pearl / High-Yield Fact**
Paraplegic patients and those with muscle damage or denervation are at increased risk of hyperkalemia when given succinylcholine, and this risk can be mitigated by using alternative neuromuscular blocking agents.
**Correct Answer: B.**