A prospective randomized controlled study was performed to assess the efficacy and safety of patient-controlled analgesia (PCA)

F. Donati PhD MD FRCFCP~'po~: The aim of this study was to assess the effect of rocuronium pretreab-,ent at 3 and 1.5 min before sucdnytcholine administration on fasdculations, neuromuscular blockade and intubating conditions.Methods: Sixty ASA I or II adults scheduled for elective surgery were anae~etised with midazolam, fentanyl, propofol, N20 and isoflurane. They were randomised in a double blind manner into three groups: group ROC-3 rain (n = 22) received 0.05 mg'kg -I rocuronium, 3 min before 2 rng-kg -I sucdnylcholine; group ROC-1,5 min (n = 20) received 0.05 mg.kg -j rocuronium 1.5 min before 2 mg'kg -I succinylcholine; and group NO ROC (n = 18) had no rocuronium before injection of 2 mg-kg -I sucdnytcholine. Fasciculations and intubating conditions were evaluated by the same physidan who was unaware of the randomisat]on. Neuromuscular block was measured at the adductor pollicis with an accelerometer. Results: The incidence of fasciculations was lower in the ROC-3 rain (9%) and ROC-1.5 rain (30%) groups than in the NO ROC group (83%; P < 0.00 I). The intensity of fasciculations was also less in both p~nt groups. No statistical difference was noted between pretreatment at 3 and 1.5 rain. Intubating conditions, onset time and duration of succinylcholine blockade were comparable in all three groups. Conclusion:The incidence and severity ofsucdnylcholine fasciculations can be reduced by giving 0.05 mg.kg -I rocuronium either 1.5 rain or 3 rain before succinylcholine. The effects of 2 mg-kg -I succinylcholine with rocuronium pretmatment, and I mg-kg -j succinyIcholine, without pretreatment, are similar with respect to intubating conditions, onset of paralysis and duration of blockade.Objectif : ~valuer I'influence du rocuronium administr6 3 et 1,5 min avant la succinytcholine sur les fasciculations, le bloc neuromusculalre et les conditions d'intubation, M~d~odes : Soixante patients ASA Iet II programmds pour une chirurgie non urgente ont dt6 anesth~si6s avec du miclazolam, du fentanyl, du propofol et de I'isoflurane. IIs ont 6t6 assignds al6atoirement et en double aveugle trois groupes : le groupe ROC-3 min (n = 22) a regu le rocuronium 0,05 mg.kg -~ 3 min avant la succinylcholine 2 mg-kg -~ ; le groupe ROC-1,5 min (n = 20) a re(iu le rocuronium 0,05 mg.kg -~ 1,5 min avant la succinytcholine 2 mg-kg -jet le groupe NO ROC (n = 18) n'a pas re~u de rocuronium avant I'injection de la succinylcholine I mg.kg -~. Un m~me m6decin non inform~ de la randomisation a ~alu6 les fasciculations et les conditions d'intubation. Un acc61drom~re a servi ~ mesurer le bloc neuromusculaire au niveau de I'adducteur du pouce.IMmdtats : l'incidence des fasdculations ~ plus bible dans les groupes ROC-3 min (9%) et ROC-1,5 min (30%) que dans le groupe NO ROC (83% ; P < 0,001 ). Les fasciculations ~taient aussi moins intenses dans les deux groupes pr~'-ait6s mais sans diff6rence statistique entre 3 et 1,5 rain. Les conditions d'intubation, la vitesse d'installation et la dur~e d'action du bloc ~ la succinylcholine ne diff6raient pas en...