Evaluation of the chemical stability of succinylcholine chloride stored in syringes under room-temperature conditions
Background: Succinylcholine chloride is essential for achieving neuromuscular blockade during emergency airway management. The manufacturer specifies a 14-day stability period for 20 mg/mL vials at room temperature, which limits implementation of prefilled-syringe protocols. Aim: This study aims to investigate the chemical stability of succinylcholine chloride after transfer from manufacturer vials to polypropylene syringes during extended room-temperature storage. Methods: A validated high-performance liquid chromatography with ultraviolet detection (HPLC-UV) method was developed to quantify percent recovery. Ten 20 mg/mL succinylcholine chloride vials were used: five samples were stored refrigerated (2–8°C; controls; n = 5), and five were transferred to polypropylene syringes and stored at room temperature (20–25°C; n = 5). Samples were analyzed over 90 days. The HPLC-UV method met United States Pharmacopeia criteria for accuracy, precision (<5% error and % relative standard deviation), and linearity (R2 > 0.99). Results: Succinylcholine chloride maintained >90% of the initial concentration over 90 days in polypropylene syringes stored at room temperature (93.13% on day 90) and in refrigerated controls (93.97% on day 90). No significant differences were observed between storage conditions (p>0.05). All samples remained physically stable, with no visible color change or precipitate. Conclusion: Despite its ester bonds, succinylcholine chloride remained chemically stable in polypropylene syringes for up to 90 days at room temperature. Relevance for Patients: These findings support the extended stability of prefilled succinylcholine syringes, which may improve emergency preparedness; however, sterility validation remains necessary before clinical implementation.
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