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Succinyl Choline possess unique properties of rapid onset and short duration of action to facilitate endo tracheal intubation but myalgias, hyperkalemia, increase in serum myoglobin, creatine phosphokinase and masseter spasm are adverse effects associated with its use in apparently healthy population. The aim of present study is to compare the effects of with and without pretreatment with magnesium sulphate and propofol induction on serum creatine phosphokinase and urinary myoglobin levels associated with use of succinyl choline. 60 patients aged between 18-60 years of both sexes of ASA Grade-I and II undergoing elective Surgery with minimal or no muscle damage were divided into two groups randomly. After taking informed consent, patient was shifting to operation table, monitors were connected, vital parameters recorded, intravenous line secured and 2ml of blood was collected in plain bottle and 10-15ml of urine sample was collected and set to lab for serum creatine phosphokinase and urinary myoglobin estimation. Patients of both groups were preoxygenated for 5 minutes, premedicated with Inj. Gycopyrolate (0.2mg) iv, Inj. Fentanyl 2 Micro Grams per Kg iv and induced with Inj. Propofol 2mg/kg and succinyl choline 2mg./kg was given to facilitate endotracheal intubation. One group was pretreated with 10cc of 0.9% Normal saline and other group with magnesium sulphate 40mg/kg in 10ml slowly over 10 minutes before induction with propofol. The occurrence of fassiculations was noted. 10-15ml of urine was collected in both groups for myoglobin estimation 20 minutes after intubation. At the end of surgery patients was revered with neostigmine (0.07mg/kg) and Inj. Glycopyrdate (0.01mg/kg). After complete recovery extubation was done and patient shifted to postoperative ward 2ml of blood was collected 20-24 hours post-surgery for serum creatine phosphokinare estimations and results tabulated. The study found that there was raise in serum phosphokinase levels in both groups. The raise was significantly lower in magnesium sulphate group compared to other group, urinary myoglobin was detected in both groups but significantly lower in magnesium sulphate group. Fasiculations and postoperative myalgias were significantly lower in magnesium sulphate group. In conclusion magnesium sulphate is effective in lowering serum creatine phosphokinase levels, urinary myoglobin levels, postoperative myalgias and fasiculations associated with use of succinyl choline.

Spinal anesthesia has become most commonly used and choice of anaesthesia for surgeries on lower half of body after first planned spinal anaesthesia for surgery in man was administered by August Bier (1861–1949) on 16 August 1898, in Kiel(1), Germany. Coadministration of adjuvant drugs improve the quality and duration of anesthesia and analgesia and patient safety. To compare effects of Dexmedetomidine and Fentanyl as adjuvants to 3ml of 0.5% heavy bupivacaine injected intrathecally, in lower abdominal surgeries. Prospective randomized comparative study. The study was approved by ethics committee and was conducted in 100 randomly selected patients posted for elective lower abdominal surgeries in the age group 18-60yrs belonging to both sex. Patients were divided into two groups- Group D (n=50) - received 5μg Dexmedetomidine+3ml 0.5% heavy bupivacaine, Group F(n=50)-received 25μg Fentanyl +3ml 0.5% heavy bupivacaine, intrathecally respectively.In groupD patients onset of sensory block was significantly faster 2.62±0.56 mins (p<0.001) with better haemodynamic stability, intraoperative sedation, less incidence of side effects and analgesic sparing effect in post operative period when compared to group F.αadrenergic agonist dexmedetomidine is a valuable adjunct to spinal anaesthesia it augments quality of spinal anaesthesia provides intraoperative sedation and hemodynamic stability.

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