Comparision of Defasciculation dose Vecuronium and Intravenous Lidocaine for Preventing Succinylcholine Induced Muscle Fasciculation and Post-Operative Myalgia Among Adult Surgical Patient at Tikur Anbessa Specialized Hospital: 2022/23. a Prospective Cohort Study
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Date
2023-07-23
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Addis Ababa University
Abstract
Because of its inexpensive cost, quick start, quick duration of action, and profound muscular relaxation, succinylcholine is commonly utilized, but it also has a number of side effects, such as fasciculation, postoperative myalgia, and an elevation in serum potassium. It may cause the patient to feel worse than the discomfort from the surgical site, especially for day-case patients whose discharge from the hospital could be delayed by postoperative myalgia. There is no known cure for succinylcholine-induced myalgia because the genesis of the condition is poorly understood.
Objective: To Compare the defasciculation dose of vecuronium and intravenous lidocaine for preventing succinylcholine-induced muscle fasciculation and post-operative myalgia among adult surgical patients at Tikur Anbessa Specialized Hospital 2022/23.
Methods: A prospective cohort studywascarried out on 88 adult surgical patientswho underwentelective surgery under general anesthesia with succinylcholine. The study participantswererandomlysplit into twogroups, according to pre-treatment with Vecuronium 0.01mg/kg and IV lidocaine 1.5mg/kg. Then,the severity of fasciculation and myalgia on postoperative day 1was recorded. Analysiswasdone byusing SPSS version 25 software and statistical analysis was done by independentt-test and chi-square test. P<0.05 was considered statistically significant
Results: In the defasciculating dose of vecuronium and IV lidocaine groups, respectively, the overall incidence of succinylcholine-induced fasciculation was 11 (25%) and 32 (72%) correspondingly. In the defasciculating dose of the vecuronium group compared to the IV lidocaine group, the intensity of fasciculation was lessened more (p=0.0001). In the defasciculating dose of vecuronium and IV lidocaine groups, the incidence of myalgia was 22 (50%) and 10(22.7%), respectively. The study's findings demonstrated that on day one, post-operative myalgia (POM) was considerably less common in the lidocaine group than in the vecuronium group (p=0.005).
Conclusion and recommendation: pretreatment with vecuronium reduced the incidence and severity of succinylcholine-induced fasciculation in comparison with the lidocaine groupHowever, POM was markedly reduced in the lidocaine group compared to the vecuronium group. We recommend usinga defasciculating dose of vecuroniumas a pretreatment to reduce succinylcholine induced fasciculation and IV lidocaine for POM.
Keywords: succinylcholine, fasciculation, myalgia, , vecuronium, lidocaine, adult surgical
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Keywords
succinylcholine, fasciculation, myalgia, , vecuronium, lidocaine, adult surgical