Postoperative Muscle Pains and Suxamethonium

Brodsky, Jay B.; Ehrenwerth, Jan

doi:10.1093/bja/52.2.215

Cited by 24 publications

(6 citation statements)

References 13 publications

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“…Only mild myalgia occurred in both group, 10% in the saline group, and 5% in the remifentanil group. Thus, the results of the present study correspond with studies reporting that there is no direct correlation between intensity of fasciculation and frequency of myalgia, and it is more likely that the etiology of myalgia is multifactorial 6,14-16. The results also correspond with the study reporting that the use of opioid during induction is not related with postoperative myalgia 5…”

Section: Discussionsupporting

confidence: 89%

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Remifentanil Attenuates Muscle Fasciculations by Succinylcholine

Yun

Kim

et al. 2010

Yonsei Med J

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PurposeThe present visual and electromyographic study was designed to evaluate muscle fasciculations caused by succinylcholine in adults pretreated with either remifentanil 1.5 µg/kg or saline.Materials and MethodsThe effect of remifentanil on succinylcholine-induced muscle fasciculations was studied using a double-blind method in 40 adults. After i.v. pretreatment with either remifentanil 1.5 µg/kg (remifentanil group, n = 20) or an equivalent volume of i.v. saline (saline group, n = 20), patients were anaesthetized with a 2.0 mg/kg of i.v. propofol followed by i.v. succinylcholine 1.0 mg/kg. Intensity and duration of muscle fasciculation following i.v. succinylcholine administration were recorded. Electromyography (EMG) was used to quantify the extent of muscle fasciculation following i.v. succinylcholine injection. Myalgia was evaluated 24 hours after induction time. Serum potassium levels were measured five minutes after i.v. succinylcholine administration and creatine kinase (CK) levels 24 hours after induction time.ResultsCompared to saline treated controls, remifentanil decreased the intensity of muscle fasciculations caused by i.v. succinylcholine [fasciculation severity scores (grade 0 to 3) were 2/1/12/5 and 3/13/4/0 (patients numbers) in the saline group and the remifentanil group, respectively, p < 0.001]. The mean (SD) maximum amplitude of muscle action potential (MAP) by EMG was smaller in the remifentanil group [283.0 (74.4) µV] than in the saline group [1480.4 (161.3) µV] (p = 0.003). Postoperative serum CK levels were lower in the remifentanil group (p < 0.001). Postoperative myalgia was not different between the two groups.ConclusionRemifentanil 1.5 µg/kg attenuated intensity of muscle fasciculations by succinylcholine.

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Section: Discussionsupporting

confidence: 89%

“…Succinylcholine induced fasciculation may be a causative factor of an increase in intraocular, intracranial, or intragastric pressure 5. Also, even though there are a few recent studies that show otherwise,5,6 it is a widespread belief that fasciculation is the major cause of postoperative myalgia 7,8…”

Section: Introductionmentioning

confidence: 99%

Remifentanil Attenuates Muscle Fasciculations by Succinylcholine

Yun

Kim

et al. 2010

Yonsei Med J

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“…There have been suggestions that fasciculations and muscle pains are related [1, 33, 34]. Although pretreatment decreases the incidence of fasciculations significantly, most investigators agree that the severity of fasciculations has no direct correlation with the frequency of postoperative myalgia [12, 22, 35–39]. However, most of these studies did not have sufficiently large subject groups to be able to provide definitive answers.…”

Section: Mechanisms Of Postoperative Myalgiamentioning

confidence: 99%

“…The extent of surgery is also important. Patients who undergo minor operations are more likely to complain of postoperative myalgia [12]. Early ambulation increases both the likelihood of the development of pain and its severity [2, 13, 14].…”

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confidence: 99%

Succinylcholine‐associated postoperative myalgia

Wong

Chung

2000

Anaesthesia

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SummaryThe subject of postoperative myalgia associated with the use of succinylcholine is reviewed. We discuss the mechanisms of succinylcholine-induced myalgia and the techniques available to prevent and treat the myalgia. In situations where patients are at risk of developing myalgia and succinylcholine is the neuromuscular blocker of choice, the use of a combination of techniques may prove to be a useful strategy.

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“…The state of training of the muscle has also been implicated, with a lower incidence and decreased severity of pain in patients with better muscular fitness [10]. Patients who undergo minor procedures and those who are ambulated earlier are at higher risk for the development of postoperative myalgias [7,21].…”

Section: Discussionmentioning

confidence: 99%

Succinylcholine-Induced Postoperative Myalgia: Etiology and Prevention

et al. 2018

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Succinylcholine is a neuromuscular blocking agent frequently used to facilitate endotracheal intubation during general anesthesia. It is usually preferred due to its rapid onset of action and short duration of action. However, the effectiveness of this drug is limited by certain adverse effects, one of which is postoperative myalgia. Although generally considered a minor adverse effect, the myalgia may be severe and interfere with return to normal activities of daily life. We present an 18-year-old with a history of ulcerative colitis who presented for anesthetic care during liver biopsy. Due to comorbidities including obesity, succinylcholine was chosen to provide rapid neuromuscular blockade and facilitate endotracheal intubation. Postoperatively, the patient complained of bilateral calf pain. The etiology of muscle pain related to succinylcholine is discussed and potential strategies to reduce its incidence reviewed.

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Postoperative Muscle Pains and Suxamethonium

Cited by 24 publications

References 13 publications

Remifentanil Attenuates Muscle Fasciculations by Succinylcholine

Remifentanil Attenuates Muscle Fasciculations by Succinylcholine

Succinylcholine‐associated postoperative myalgia

Succinylcholine-Induced Postoperative Myalgia: Etiology and Prevention

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