Evaluation of succinylcholine-induced fasciculations & myalgias with or without atracurium pretreatment

Pretreatment regimens that decrease the incidence of fasciculations

and postoperative myalgias have been the focus of many

research studies. The subject of pretreatment remains

controversial. An experimental double blind study was

conducted of 50 patients, men and women, aged 18 to 65 years

who were having elective minor orthopedic surgery. Group A

participants (n = 24) received normal saline, and group B

participants (n = 26) received atracurium 0.05 mg/kg, followed

by succinylcholine 1.5 mg/kg. Data that were collected

included age, ASA physical status, weight, height, anesthesia

and postanesthesia recovery times, type of procedure,

medications administered, and allergies. Phase I of the study

consisted of evaluation for the presence of fasciculations. In

phase II, the intubation conditions (e.g., character of the

vocal cords, presence of coughing, and degree of ease with

laryngoscopy) were evaluated. Phase III included evaluation of

postoperative myalgias at 24 and 72 hours. Data were analyzed

using measures of central tendency, chi square, Pearson’s r

and the Student’s t test. The incidence of fasciculations was

less in the atracurium pretreatment group (group B) than in

the group treated with normal saline (group A). Intubation

conditions were not compromised by atracurium pretreatment.

There was no statistically significant difference between

group B and group A in postoperative myalgias. Thus, no

recommendations for pretreatment can be made on the basis of

this study.

Hochhalter CM

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