Diazepam and suxamethonium muscle pain (a dose‐response study)

Abstract

Postoperative muscle pain following suxamethonium is a well known problem.',* Recently it has been reported that diazepam has protective effects against these muscle pains3 This study was taken to confirm this observation and also to observe a dosc rclatcd cffcct of diazepam on suxamethonium pains. Muterid und method.,Various factors such as age, sex, type and duration of' operation. body weight. body position and anaesthetic technique may affect the incidence of suxaniethonium pains. In this study female patients of average body weight 40 kg. aged 20 to 45 years, of physical status 1 in the ASA classification, undergoing tuba1 ligation were studied. Patients with cardiac. respiratory. renal and neurological disorders were excluded. All patients were hospitalised and were ambulatory 6 to 8 hours after operation. Patients were given various doses of diazepam (Table I). It was planned to have 25 patients in each group, but in the diazepam group nine paticnts given a dose of 5 mg diazepam required an additional dose of suxamethonium and have. therefore. been excluded from the series.All patients werc given atropine 0.65 mg intravenously prior to induction. No other drugs were used. .,. Experimrn~al Diazepam given ~~Anaesthesia for the patients in the control group was induced with 250 mg thiopentone. The same dose was uscd in all patients becausc of the infucnce of thiopentone on the incidence of pain after administration of s u~a m e t h o n i u m .~ Suxamethonium 50 mg was given immediately after the thiopentone as a single injcction. Anaesthesia was maintained with oxygen and ether through a sem-closed circuit. Thc same tcchnique was employed in the experimental group except that diazepam in 5. 10. 15 and 20 mg doses was given intravenously 5 minutes prior t o suxamethonium.Postoperatively paticnts were asked about muscle pains by a doctor who was unaware of the drugs used

The effect of cetylated fatty esters and physical therapy on myofascial pain syndrome of the neck

“…b. Clonazepam has an antinociceptive effect for pain with chronic MPS (Fishbain et al, 2000). Similar analgesic effects have been reported for alprazolam (Russell et al, 1991), diazepam (Verma, 1982), midazolam (Serrao et al, 1992) and buprenorphine injections (particularly with significant neuropathic component present; Likar and Sittl, 2005). Opioids, however, may be addictive, with sedation a common side effect.…”

Clonazepam Open Clinical Treatment Trial for Myofascial Syndrome Associated Chronic Pain: Table 1

“…Analgesic effects have also been reported with other benzodiazepines, such as alprazolam [40–42], diazepam [43–44], and midazolam [45–46]. This effect may be related to the facilitation of GABA‐ergic neurotransmission by benzodiazepines, which could in turn activate medullary neurons involved in pain inhibition [47].…”

Oral diazepam premedication reduces the incidence of post-succinylcholine muscle pains

“…3 There is disagreement in the literature regarding the effect of diazepam on fasciculations. Erkola et al 4 and this study showed no significant change.…”