Suxamethonium after burns — FRCA Primary MCQ

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ModeratePharmacologySuxamethonium after burnsFRCA Primary

A 35-year-old man presents for debridement 10 hours after a 25% thermal injury. He has no renal impairment and potassium is 4.3 mmol L-1. Rapid sequence induction is planned. Which drug is most appropriate to facilitate intubation?

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Correct answer: E — Vecuronium 0.01 mg kg-1

Suxamethonium is generally safe in the first 24 hours after a burn before extrajunctional acetylcholine receptor proliferation creates a major hyperkalaemia risk. The tempting distractor is rocuronium, but it is not offered here and the question asks within the early safe window. Small doses of non-depolarising drugs listed would not reliably provide rapid intubating conditions. The danger with suxamethonium after burns becomes important from roughly 24 hours onwards.

Reference: RCoA Primary FRCA Syllabus 2026; Peck, Hill & Williams Pharmacology for Anaesthesia