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Canadian Journal of Anaesthesia

, Volume 34, Issue 3, pp 238–241 | Cite as

Decreasing post-succinylcholine myalgia in outpatients

  • Brian Melnick
  • Jagadamba Chalasani
  • Nonita T. Lim
  • Preyaratt Phitayakorn
  • Susan V. Mallett
  • Thomas E. Rudy
Article

Abstract

The effectiveness of four pretreatment regimens in decreasing succinylcholine-induced myalgias was studied in healthy outpatients undergoing general anaesthesia for ambulatory surgery. Four hundred and forty adult females were randomly assigned to one of four pretreatment groups. Three hundred and ninety-five patients completed the study. One of the following pretreatments was given prior to injection of 1.5 mg·kg-1 of succinylcholine: (1) normal saline IV three minutes and again immediately prior to succinylcholine; (2) 0.06 mg-kg-1 d-tubo-curarine (dTc) IV three minutes prior and normal saline IV immediately prior; (3) normal saline IV three minutes prior and 1.5 mg·kg-1 lidocaine TV immediately prior; (4) 0.06mg·kg-1 dTc IV three minutes prior and 1.5 mg·kg-1 lidocaine IV immediately prior. Fasciculations after injection of succinylcholine were observed and recorded. Patients were contacted by telephone 40-48 hours postoperatively and questioned about the presence of muscle pains. These pains, if present, were graded either mild or moderate to severe. The patients in the two dTc-containing groups exhibited less fasciculations than patients in the other two experimental groups. The dTc-lido-caine group had a lower incidence of moderate to severe fasciculations than in any of the other three groups. Patients in the dTc, Udocaine, and dTc-lidocaine experimental groups reported a higher incidence of absence of muscle pain and a lower incidence of moderate-severe pain than did patients in the saline group. The dTc-lidocaine group had more patients without myalgia and less patients with moderate to severe myalgias than any of the other groups. Only 8.3 per cent of the patients in the dTc-lidocaine group reported muscle pains. We conclude that a pretreatment regimen consisting of 0.06 mg·kg-1 dTc IV three minutes prior to injection of succinylcholine, along with 1.5 mg·kg-1 Udocaine TV immediately prior to succinylcholine is very effective in decreasing succinylcholine induced fasciculations and myalgia in outpatients.

Key words

neuromuscular relaxants:succinylcholine tubocurarine anaesthetics local: lidocaine complications:myalgia 

Résumé

Ľefficacité de quatre méthodes de prétraitement afin de diminuer les myalgies induites par la succinylcholine ont été étudiées chez les patients sains devant subir une chirurgie ambulatoire. Quatre-cent-quarante patients ont été assignés au hasard afin de recevoir un des quatre mode de prétraitement: 1) soluté physiologique, 2) d-tubocurarine (dTc), 3) lidocaine, 4) combinaison de dTc-lidocaine. Les fasciculations aprés ľadministration intraveineuse de succinylcholine étaient observées et enregistrées. Les malades furent consultés entre 40 et 48 heures postopératoires et ont été interrogés sur la présence de douleur et de myalgies qu’on a classifié comme légére, modeste ou sévére. Les groupes de patients ayant reçu la d-tubocurarine ont montré moins de myalgie que les autres. Les patients du groupe dTc-lidocaine ont eu une incidence totale de myalgie plus basse que les autres groupes et ont accusé moins de myalgie modeste ou sévére. On néa pas démontré aucune corrélation entre les fasciculations et les myalgies. En conclusion ces résultats suggérent que le prétraitement avec du dTc-lidocaine est plus efficace pour prévenir es myalgies post succinylcholine chez les patients ambulants.

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Copyright information

© Canadian Anesthesiologists 1987

Authors and Affiliations

  • Brian Melnick
    • 1
  • Jagadamba Chalasani
    • 1
  • Nonita T. Lim
    • 1
  • Preyaratt Phitayakorn
    • 1
  • Susan V. Mallett
    • 1
  • Thomas E. Rudy
    • 1
  1. 1.Department of AnesthesiologyUniversity of Pittsburgh, School of Medicine and Magee-Women’s HospitalPittsburghPennsylvania

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