# 哪一位個案不應接受succinylcholine進行快速順序插管？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391878&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

哪一位個案不應接受succinylcholine進行快速順序插管？

## 選項

1. 重大燒傷超過24小時、脊髓損傷超過72小時或橫紋肌溶解的個案；有危及生命的高血鉀風險 **✔ 正確答案**
2. 使用lisinopril控制高血壓的個案
3. 闌尾炎且檢驗值正常的個案
4. 輕微季節性過敏的個案

**正確答案: 1**

## 解析

正確（2）：Succinylcholine會使鉀離子由肌肉外流。若存在接合部外acetylcholine受體上調，例如重大燒傷超過24小時、脊髓損傷超過72小時、長期不動、去神經損傷、肌肉失養症、橫紋肌溶解，血鉀急升可導致心跳停止。應改用非去極化NMBA（rocuronium）。（1,3,4）不是禁忌。

## 深入解析

記憶提示 Succinylcholine高K風險 =「燒傷、SCI、中風、肌肉失養、去神經、橫紋肌溶解」。安全替代：rocuronium。若K已>5應避免。

## 臨床情境

情境 急診需為重症個案進行快速順序插管；手邊有succinylcholine。

## 重要概念

- **去極化NMBA** — Succinylcholine；唯一去極化藥物；起效快、作用時間短。
- **高血鉀風險狀態** — 燒傷、SCI、橫紋肌溶解、長期不動、去神經時應避免succinylcholine。
- **非去極化NMBA** — Rocuronium、vecuronium、cisatracurium；相較succinylcholine起效/持續時間較長。

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