Abstract
BackgroundThe onset of paralysis by succinylcholine is usually signaled by visible motor unit contractions called fasciculation. Even though it is a short-acting muscle relaxant of choice that facilitates endotracheal intubation, it has some side effects. The most common side effects are fasciculation and post-operative myalgias which are unpleasant experiences for the patient lasting 24–48 h after surgery. The current study aimed to compare the effect of a mini-dose of succinylcholine versus a de-fasciculating dose of pancuronium for the prevention of succinylcholine-induced side effects in surgical patients. MethodsThis is a prospective cohort study that recruited 96 patients who underwent elective surgery. Patients were grouped into three study arms: 1. 0.01mg/kg pancuronium, 2. 0.2mg/kg succinylcholine, and 3. with no pretreatment. Data were analyzed using one-way analysis of variance (ANOVA) with post hoc analysis for multiple tests and non-normally distributed data were analyzed using the Kuruska-Wallih H rank test. P-values < 0.05 were considered as statistically significant. ResultsThe total incidence of succinylcholine-induced fasciculation was 17 (53.1%), 8(25%), and 30 (93.8%) in pancuronium, mini-dose of succinylcholine pretreatment and unexposed groups, respectively (p<0.001). The severity of fasciculation was reduced more in mini-dose succinylcholine than in the other two groups. The total incidence of myalgia was 6(18.8%), 3(9.4%), and 9(28.1%) in pancuronium, mini-dose of succinylcholine, and unexposed groups, respectively (p=0.158). There was no difference in the severity of myalgia between groups (p=0.161). There was no statistically significant difference in the incidence and severity of succinylcholine-induced postoperative myalgia among the three groups. ConclusionPretreatment with a mini-dose of succinylcholine might reduce the incidence and severity of succinylcholine-induced fasciculation in patients undergoing elective surgery. In this study, pre-treatment with a mini-dose of succinylcholine or pancuronium did not demonstrate an effect on the incidence or severity of succinylcholine-induced myalgia.
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