Remifentanil attenuates muscle fasciculations by succinylcholine.

Abstract

PURPOSE:

The present visual and electromyographic study was designed to evaluate muscle fasciculations caused by succinylcholine in adults pretreated with either remifentanil 1.5 microg/kg or saline.

MATERIALS AND METHODS:

The effect of remifentanil on succinylcholine-induced muscle fasciculations was studied using a double-blind method in 40 adults. After i.v. pretreatment with either remifentanil 1.5 microg/kg (remifentanil group, n = 20) or an equivalent volume of i.v. saline (saline group, n = 20), patients were anaesthetized with a 2.0 mg/kg of i.v. propofol followed by i.v. succinylcholine 1.0 mg/kg. Intensity and duration of muscle fasciculation following i.v. succinylcholine administration were recorded. Electromyography (EMG) was used to quantify the extent of muscle fasciculation following i.v. succinylcholine injection. Myalgia was evaluated 24 hours after induction time. Serum potassium levels were measured five minutes after i.v. succinylcholine administration and creatine kinase (CK) levels 24 hours after induction time.

RESULTS:

Compared to saline treated controls, remifentanil decreased the intensity of muscle fasciculations caused by i.v. succinylcholine [fasciculation severity scores (grade 0 to 3) were 2/1/12/5 and 3/13/4/0 (patients numbers) in the saline group and the remifentanil group, respectively, p < 0.001]. The mean (SD) maximum amplitude of muscle action potential (MAP) by EMG was smaller in the remifentanil group [283.0 (74.4) microV] than in the saline group [1480.4 (161.3) microV] (p = 0.003). Postoperative serum CK levels were lower in the remifentanil group (p < 0.001). Postoperative myalgia was not different between the two groups.

CONCLUSION:

Remifentanil 1.5 microg/kg attenuated intensity of muscle fasciculations by succinylcholine.

• Authors: Mi Ja Yun, Yoon Hee Kim, Young Kwon Go, Ji Eun Shin, Choon Gun Ryu, Won Kim, Nam Jong Paik, Moon Ku Han, Sang Hwan Do, Woo Suk Jung
• Journal: Yonsei medical journal (Yonsei Med J) Vol. 51 Issue 4 Pg. 585-9 (Jul 2010) ISSN: 1976-2437 [Electronic] Korea (South)
• PMID: 20499427 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Piperidines
• Creatine Kinase
• Succinylcholine
• Remifentanil

Topics

• Adult
• Aged
• Blood Pressure (drug effects)
• Creatine Kinase (blood)
• Double-Blind Method
• Electromyography
• Fasciculation (chemically induced, drug therapy)
• Female
• Humans
• Male
• Middle Aged
• Piperidines (therapeutic use)
• Remifentanil
• Succinylcholine (adverse effects)