Effect of Pre-Treatment with Rocuronium on Serum Potassium, PostSuccinylcholine Fasciculations, and Myalgia Postoperatively
Creators
- 1. Associate Professor, Department of Anaesthesiology, Chhindwara Institute of Medical Sciences, Chhindwara, MP, India
- 2. Assistant Professor, Department of Ophthalmology, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India
- 3. Assistant Professor, Department of Anaesthesiology, Bundelkhand Medical College, Sagar, Madhya Pradesh, India
- 4. Demonstrator, Department of Biochemistry, Chhindwara Institute of Medical Sciences, Chhindwara, MP, India
Description
Background: The best drug for endotracheal intubation is succinylcholine, which has a rapid onset, an extremely brief duration of action, and complete predictable paralysis. However, muscle fasciculations, postoperative myalgia, an increase in serum potassium level, and myoglobinuria can occur and limit the drug’s use in conditions like full stomachs, burns, significant trauma, metabolic acidosis, and a few myopathies. Numerous medications have been researched with the purpose of attenuating these effects; however pre-treatment with a non-depolarizing muscle relaxant has proven to be effective. Aims and Objective: The purpose of this study was to evaluate the impact of pre-treatment with rocuronium on post-succinylcholine fasciculations, an increase in serum potassium levels, and postoperative myalgia. Material and Methods: 100 patients (20–50 years old, either sex; ASA grades I and II) having general anaesthesia for different surgical operations were divided into two groups at random, one for pre-treatment using rocuronium (Group R), and the other for pre-treatment with saline (Group P), before succinylcholine injection. On postoperative days 1, 2, and 3 following succinylcholine injection, the intensity of fasciculations, an increase in potassium levels in the blood after 5 minutes, and myalgia were noted. Results: In Group R, 74% of patients had no fasciculation, compared to 36% in Group P. Both groups experienced an increase in blood potassium levels that was statistically insignificant (p>0.05). On postoperative days 2 and 3, a greater proportion of patients in the placebo group experienced mild to severe myalgia. Conclusion: With a statistically non-significant elevation in serum potassium levels, pre-treatment with rocuronium before succinylcholine resulted in greater attenuation of post-succinylcholine muscular fasciculations and postoperative myalgia.
Abstract (English)
Background: The best drug for endotracheal intubation is succinylcholine, which has a rapid onset, an extremely brief duration of action, and complete predictable paralysis. However, muscle fasciculations, postoperative myalgia, an increase in serum potassium level, and myoglobinuria can occur and limit the drug’s use in conditions like full stomachs, burns, significant trauma, metabolic acidosis, and a few myopathies. Numerous medications have been researched with the purpose of attenuating these effects; however pre-treatment with a non-depolarizing muscle relaxant has proven to be effective. Aims and Objective: The purpose of this study was to evaluate the impact of pre-treatment with rocuronium on post-succinylcholine fasciculations, an increase in serum potassium levels, and postoperative myalgia. Material and Methods: 100 patients (20–50 years old, either sex; ASA grades I and II) having general anaesthesia for different surgical operations were divided into two groups at random, one for pre-treatment using rocuronium (Group R), and the other for pre-treatment with saline (Group P), before succinylcholine injection. On postoperative days 1, 2, and 3 following succinylcholine injection, the intensity of fasciculations, an increase in potassium levels in the blood after 5 minutes, and myalgia were noted. Results: In Group R, 74% of patients had no fasciculation, compared to 36% in Group P. Both groups experienced an increase in blood potassium levels that was statistically insignificant (p>0.05). On postoperative days 2 and 3, a greater proportion of patients in the placebo group experienced mild to severe myalgia. Conclusion: With a statistically non-significant elevation in serum potassium levels, pre-treatment with rocuronium before succinylcholine resulted in greater attenuation of post-succinylcholine muscular fasciculations and postoperative myalgia.
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Additional details
Dates
- Accepted
-
2023-05-26
Software
References
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