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Rocuronium is the best non-depolarizing relaxant to prevent succinylcholine fasciculations and myalgia.

AbstractPURPOSE:
To determine which non-depolarizing relaxant among d-tubocurarine, vecuronium, atracurium, mivacurium and rocuronium prevented muscular fasciculations and myalgia following succinylcholine.
METHODS:
In this double blind randomized study, 120 female patients scheduled for laparoscopic procedures were studied. They were divided into six groups of 20 according to the non-depolarizing pretreatment used: NaCl 0.9% (control), 0.05 mg.kg-1 d-tubocurarine, 0.01 mg.kg-1 vecuronium, 0.05 mg.kg-1 atracurium, 0.02 mg.kg-1 mivacurium and 0.06 mg.kg-1 rocuronium. Four minutes after the pretreatment, 1.5 mg.kg-1 succinylcholine was injected. Side effects of the pretreatment, the presence and magnitude of fasciculations, the ease of tracheal intubation, myalgia 1, 24 and 48 hr after surgery were observed. A Puritan Bennett Datex 221 NMT Relaxograph monitor was used to evaluate the neuromuscular block.
RESULTS:
Muscle fasciculations were observed in 19 of the 20 patients in the control group and in 3 of the 20 patients in the rocuronium group, the best of the pretreatments in that aspect. Four patients in the mivacurium group were unable to sustain more than four seconds head-lift after pretreatment (P < 0.05). Tracheal intubation conditions were better and the onset of block was faster and longer after succinylcholine in the control group (P < 0.05). Myalgias were present in 71% of the patients 24 hr postoperatively and the frequency was not different among the groups.
CONCLUSION:
Among the pretreatments tested, 0.06 mg.kg-1 rocuronium was the best to prevent muscular fasciculations following succinylcholine injection. In the population studied, pretreatment did not prevent postoperative myalgia. Succinylcholine 1.5 mg.kg-1 was more effective without a non-depolarizing pretreatment.
AuthorsR Martin, J Carrier, M Pirlet, Y Claprood, J P Tétrault
JournalCanadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 45 Issue 6 Pg. 521-5 (Jun 1998) ISSN: 0832-610X [Print] United States
PMID9669004 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Androstanols
  • Isoquinolines
  • Neuromuscular Depolarizing Agents
  • Neuromuscular Nondepolarizing Agents
  • Atracurium
  • Mivacurium
  • Vecuronium Bromide
  • Succinylcholine
  • Tubocurarine
  • Rocuronium
Topics
  • Adult
  • Androstanols (administration & dosage)
  • Atracurium (administration & dosage)
  • Double-Blind Method
  • Fasciculation (prevention & control)
  • Female
  • Follow-Up Studies
  • Humans
  • Intubation, Intratracheal
  • Isoquinolines (administration & dosage)
  • Laparoscopy
  • Mivacurium
  • Muscle, Skeletal (drug effects)
  • Neuromuscular Blockade
  • Neuromuscular Depolarizing Agents (adverse effects)
  • Neuromuscular Nondepolarizing Agents (administration & dosage)
  • Pain (prevention & control)
  • Rocuronium
  • Succinylcholine (adverse effects)
  • Time Factors
  • Tubocurarine (administration & dosage)
  • Vecuronium Bromide (administration & dosage)

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