Background: Suxamethonium remains the best option for rapid sequence induction, it is the only depolarizing muscle relaxant in clinical use. However, fasciculation and myalgia are frequent adverse effects of the drug. Myalgia can last for several days with associated discomfort. Non-depolarizing muscle relaxant and magnesium sulphate have been tried as pretreatments to attenuate the fasciculation and myalgia with varying results.Methods: A double blind, randomized study of 100 adult surgical patients of ASA I or II Class were recruited to receive either intravenous atracurium (0.05mg/kg) (Group A) or intravenous magnesium sulphate (30mg/kg)(Group B). The occurrence, severity and duration of fasciculation as well as the occurrence and severity of post-operative myalgia were also recorded.Results: Muscle fasciculation occurred in 39 (78%) patients in Group A and 27(54%) patients in Group B (p= 0.001). The severity of fasciculation was mild to moderate in Group B while Group A in addition also recorded some cases of severe episodes of fasciculation. Mean duration of fasciculation in Group A waslonger (28.48 ± 1.07sec) than in group B (19.44± 1.93seconds) (p= 0.001). Post-operative myalgia was not experienced at 6hrs and 48hrs, while 2 patients (1 in each Group) had it at 12hrs. At 24hrs, postoperative myalgia was present in 13(26%) patients in group A and 5(10%) patients in group B, (p=0.043). The severity of post-operative myalgia recorded both at 12hrs and 24hrs was mild.Conclusion: Magnesium sulphate demonstrated better efficacy at reducing fasciculation and postoperative myalgia than atracurium

Introduction: Perioperative management of patients with corona virus disease 2019 (COVID-19) could be extremely challenging in order to keep the balance between providing optimal medical care and protecting health-care providers from the risk of infection. Also the respiratory effect of COVID 19 could also alter the course and outcome of surgery. Aim: We aim to report a 30-year-old COVID-19 patient who had emergency cesarean section on account of placenta praevia. Methodology: The cesarean section was done under subarachnoid block while there was no significant event perioperatively while preventive measures were taken to avoid cross infection with the managing team. Results: The patient had a safe anesthesia and surgery. Polymerase Chain Reaction (PCR) test was done fourth day after surgery was negative for the mother and child.

General anesthesia with controlled ventilation through endotracheal tube is an anaesthetic technique used by the anesthesiologists all over the world. Laryngoscopy and endotracheal intubation is necessary to achieve this technique. Traditionally succinylcholine is drug of choice for induction due to its rapid onset of action. Aim: This study compared the efficiency of magnesium sulphate in reducing fasciculation and increase in serum potassium which are the common complications associated with suxamethonium administration. Methods: Fifty six patients being planned for lower abdominal surgery under general anaesthesia were randomized into two groups M and S. Serum potassium was taken in the theatre, three minutes before induction of anesthesia patients in M group were given 6 mg/kg of magnesium sulphate diluted in 10 ml normal saline intravenously while in S group 10 ml of normal saline was injected intravenously. The occurrence and degree of fasciculation were recorded after administration of suxamethonium in both groups while serum potassium was also taken at the end of fasciculations. The researcher was blinded to the content of the syringes until after the study. Results: More patients in the S group had fasciculations compared to the M group while the degree of fasciculations was more in the S group, the serum potassium increase was more in the saline group.