Effect of repeat bolus dose of propofol on succinylcholine-induced fasciculations and myalgia

Abstract

Background: Succinylcholine-induced fasciculations and myalgia are common and troublesome for the patients. A few studies have used propofol to minimize succinylcholine-induced fasciculations and myalgia, but none of these have used a repeat bolus dose. Materials and Methods: A prospective, randomized, double blind study was designed to assess the effect of a repeat bolus dose of propofol on succinylcholine-induced fasciculations and myalgia. Ninety adult patients scheduled for elective surgery under general anesthesia were selected by computer-generated random numbers and allocated to one of the three equal groups randomly. Anesthesia was induced with intravenous injection of propofol 2 mg/kg, followed by administration of succinylcholine 1.5 mg/kg. Immediately after the injection of succinylcholine a repeat bolus of propofol was given as per group. Group I: No repeat dose of propofol; Group II: Repeat propofol bolus of 0.5 mg/kg body weight; Group III: Repeat propofol bolus of 1.0 mg/kg body weight. Muscle fasciculations were observed and graded as nil (0), mild (1), moderate (2), or severe (3). Postoperative myalgia were assessed every 6 hourly for 24 h and then at 48 h and graded as nil (I), mild (II), moderate (III), or severe (IV). Results: The overall incidence of muscle fasciculations was 73 and 33% in Groups II and III, respectively as against 90% in Group I. The incidence of postoperative myalgia was highest (86.67%) in Group I and lowest in Group III (60.0%). Conclusion: The technique of giving repeat bolus dose of propofol immediately after succinylcholine not only decreases the incidence and severity of fasciculations and postoperative myalgia, but also provides hemodynamic stability and satisfactory grade of relaxation for intubation.