Comparison of defasciculation dose pancronium and mini-dose succinylcholine for preventing succinylcholine induced muscle fasciculation and post operative myalgia among surgical patient: A prospective, cohort study
No Thumbnail Available
Date
2019-07
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Abeba University
Abstract
Background: Succinylcholine is a depolarizing skeletal muscle relaxant that remains the
accepted standard for facilitating endotracheal intubation. This medication may cause some
adverse effects in patients such as hyperkalemia, malignant hyperthermia, increased intra gastric
and intracranial pressure, fasciculation during induction, and postoperative myalgia. Although
postoperative myalgia are commonly encountered problem they may be very unpleasant
experiences for the patient till 24–48 h after surgery
.
Objective: Comparison of defasciculation dose pancronium and mini-dose succinylcholine for
preventing succinylcholine induced muscle fasciculations and post operative myalgia among
surgical patient in menelik II referral hospital.
Methodology: An institutional based prospective cohort study conducted on 96 patients
undergoing elective surgery were divided in three equal groups :After pretreatment with either
0.01mg/kg defasciculating dose of pancronium as Group (n= 32) , 0.2mg/kg mini dose
succinylcholine and 1ml NS group , patients were anesthetized with a 3-5mg/kg of Thiopental
followed by succinylcholine 2mg/kg. Data on baseline characteristics, incidence and severity of
muscle Fasciculation and post operative myalgia (after 24 hours) were collected.
Results: The demographic data of patients in three groups were comparable. The total incidence
of succinylcholine induced fasciculation were 17(53.1%) , 8(25%) and 30(93.8%) in
pancronium, mini-dose of succinylcholine pretreatment and NS Groups respectively
(p=0.000).The severity of fasciculation was reduced more in mini-dose succinylcholine
compared with pancronium group (0.012) and Normal saline group (0.000).The total incidence
of myalgia was 6(18.8%) 3(9.4%)and 9(28.1%) in pancronium , mini-dose of succinylcholine
and Normal saline Groups respectively (p=0.158).There is no difference on the severity of
myalgia between groups (p=0.161)
Conclusion and recommendation: pretreatment with mini dose of succinylcholine is effectively
reduced the incidence and severity of succinylcholine induced fasciculation in comparison with
pancronium and Normal saline group. but there was no difference in the incidence and severity
of post operative myalgia between the three groups. We recommended to use mini dose of
succinylcholine as a pretreatment to reduce succinylcholine induced fasciculation.
Description
Keywords
Defasciculation dose pancronium , mini-dose succinylcholine