Continuous propofol administration for suxamethonium‐induced postoperative myalgia

Manataki, A.; Arnaoutoglou, Helen M.; Tefa, L. K.; Glatzounis, G. K.; Παπαδόπουλος, Γεώργιος

doi:10.1046/j.1365-2044.1999.00753.x

Cited by 12 publications

(5 citation statements)

References 36 publications

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“…A comparatively larger dose of succinylcholine results in synchronous activation of muscle spindles resulting in less myalgia. 19 We observed the incidence of myalgia to be 12 (40%) in magnesium sulphate group as compared to 26 (86.6%) in the control group. These differences were found to be significant.…”

Section: Resultsmentioning

confidence: 61%

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Effect of Pretreatment With Magnesium Sulphate on Succinylcholineinduced Fasciculations and Myalgia

Raman¹,

Singh²,

Sarwer³

et al. 2016

jebmh

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BACKGROUNDSuccinylcholine, a depolarising muscle relaxant possesses a unique property of rapid onset and short duration of action, but is accompanied by side effects such as fasciculations and myalgia. A prospective randomised-controlled trial was designed to assess the effect of a combination of magnesium sulphate with propofol for induction of anaesthesia on succinylcholine-induced fasciculations and myalgia. MATERIALS AND METHODS60 adult patients of ASA status I and II of both sexes for elective surgery under general anaesthesia were randomly allocated into two equal groups, group MG and group NS. The patients of MG group were pretreated with magnesium sulphate 40 mg/kg body weight in 10 mL volume, while patients of NS group were given isotonic saline 0.9% in the same volume (10 mL) intravenously slowly over a period of 10 mins. Anaesthesia was administered with pentazocine 0.6 mg/kg and propofol 2 mg/kg, followed by administration of succinylcholine 2 mg/kg intravenously. Muscle fasciculations were observed and graded as nil, mild, moderate or severe. Postoperative myalgia was assessed after 24 hrs. of surgery and graded as nil, mild, moderate or severe. Observations were made in double blind manner where the observer and the patient were blinded. RESULTSDemographic data and baseline parameters of both groups were comparable (P>0.05). Muscle fasciculations occurred in 66.7% patients of MG group versus 100% patients of NS group with a significant difference (P<0.001). After 24 hrs. of surgery, 12 patients of MG group and 28 patients of NS group had myalgia with a significant difference (P<0.001). Statistically significant difference was found in MAP and heart rate at various intervals between the two groups (P<0.001). CONCLUSIONMagnesium sulphate 40 mg/kg intravenously maybe used with propofol for induction of anaesthesia to control succinylcholineinduced fasciculations and myalgia. KEYWORDSPropofol, Magnesium Sulphate, Succinylcholine, Fasciculations and Postoperative Myalgia. HOW TO CITE THIS ARTICLE: Raman A, Singh RK, Sarwer F, et al. Effect of pretreatment with magnesium sulphate on succinylcholine-induced fasciculations and myalgia. BACKGROUNDSuccinylcholine, a depolarising muscle relaxant was introduced in 1952 by Sleff and Foldes and has a unique place in clinical practice, because it causes quick and excellent skeletal muscle relaxation for few minutes followed by spontaneous recovery. It possesses a unique property of rapid onset and short duration of action, but is accompanied by side effects like muscular fasciculations, myalgias, masseter spasm, hyperkalaemia, rhabdomyolysis, etc. It also increases intracranial pressure, intraocular pressure and intragastric pressure. 1 The pathophysiology of fasciculations is unclear, but it may be induced by axonal depolarisation caused by connection between succinylcholine and presynaptic and cholinergic nicotinic receptors. 2 Many attempts have been made to avoid these undesirable effects, which include pretreatment with rocuronium, 3 Financial or Other, Compe...

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Section: Resultsmentioning

confidence: 61%

“…The choice of induction agent and premedication affects the incidence of myalgia. Manataki AD et al (1999) used continuous propofol infusion to control succinylcholineinduced postoperative myalgia. Postoperative myalgia is an annoying complication associated with the use of succinylcholine.…”

Section: Resultsmentioning

confidence: 99%

Effect of Pretreatment With Magnesium Sulphate on Succinylcholineinduced Fasciculations and Myalgia

Raman¹,

Singh²,

Sarwer³

et al. 2016

jebmh

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“…used continuous propofol administration to control succinylcholine-induced postoperative myalgia. [30]…”

Section: Discussionmentioning

confidence: 99%

Effect of magnesium sulfate with propofol induction of anesthesia on succinylcholine-induced fasciculations and myalgia

Kumar

Talwar

Goyal

et al. 2012

J Anaesthesiol Clin Pharmacol

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Background:Magnesium sulfate and propofol have been found to be effective against succinylcholine-induced fasciculations and myalgia, respectively, in separate studies. A prospective randomized double blind controlled study was designed to assess the effect of a combination of magnesium sulfate with propofol for induction of anesthesia on succinylcholine-induced fasciculations and myalgia.Materials and Methods:Randomly selected 60 adult patients scheduled for elective surgery under general anesthesia were allocated to one of the two equal groups by draw of lots. The patients of MG Group were pretreated with magnesium sulfate 40 mg/kg body weight in 10 ml volume, while patients of NS group were given isotonic saline 0.9% in the same volume (10 ml) intravenously slowly over a period of 10 min. Anesthesia was induced with fentanyl 1.5 mcg/kg and propofol 2 mg/kg, followed by administration of succinylcholine 2 mg/kg intravenously. Muscle fasciculations were observed and graded as nil, mild, moderate, or severe. Postoperative myalgia was assessed after 24 h of surgery and graded as nil, mild, moderate, or severe. Observations were made in double blind manner.Results:Demographic data of both groups were comparable (P > 0.05). Muscle fasciculations occurred in 50% patients of MG group versus in 100% patients of NS group with a significant difference (P < 0.001). After 24 h of surgery, no patient of MG group and 30% patients of NS group had myalgia with a significant difference (P < 0.002).Conclusion:Magnesium sulfate 40 mg/kg intravenously may be used with propofol for induction of anesthesia to control succinylcholine-induced fasciculations and myalgia.

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“…The median level of myalgia was reduced significantly in the continuous propofol group than in isoflurane group. 8 James MF, Cork RC, Dennett JE studied the effect of pretreatment with 60mg/kg Magnesium sulfate on the neuromuscular blockade and consequent potassium release produced by 1.5mg/kg Succinylcholine. They mentioned that Magnesium sulphate decreases Succinyl choline induced fasiculations.…”

Section: Graph 9: Comparison Of Occurrence Of Postoperative Myalgiasmentioning

confidence: 99%

Comparative Study on the Effects of Pretreatment With Magnesium Sulphate and Propofol Induction on Serum Creatine Phosphokinase and Urinary Myoglobin Levels Associated With the Use of Succinylcholine

Roy¹,

Mrunalini²,

Venkateshwarlu³

et al. 2015

jemds

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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.

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Continuous propofol administration for suxamethonium‐induced postoperative myalgia

Cited by 12 publications

References 36 publications

Effect of Pretreatment With Magnesium Sulphate on Succinylcholineinduced Fasciculations and Myalgia

Effect of Pretreatment With Magnesium Sulphate on Succinylcholineinduced Fasciculations and Myalgia

Effect of magnesium sulfate with propofol induction of anesthesia on succinylcholine-induced fasciculations and myalgia

Comparative Study on the Effects of Pretreatment With Magnesium Sulphate and Propofol Induction on Serum Creatine Phosphokinase and Urinary Myoglobin Levels Associated With the Use of Succinylcholine

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