Optimal precurarizing dose of rocuronium to decrease fasciculation and myalgia following succinylcholine administration.
10.4097/kjae.2014.66.6.451
- Author:
Kyu Nam KIM
1
;
Kyo Sang KIM
;
Hoon Il CHOI
;
Ji Seon JEONG
;
Hee Jong LEE
Author Information
1. Department of Anesthesiology and Pain Medicine, Hanyang University School of Medicine, Seoul, Korea. kimks@hanyang.ac.kr
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Fasciculation;
Myalgia;
Neuromuscular blockade;
Precurarization;
Rocuronium;
Succinylcholine
- MeSH:
Fasciculation*;
Humans;
Incidence;
Myalgia*;
Neuromuscular Blockade;
Neuromuscular Monitoring;
Succinylcholine*;
Ulnar Nerve
- From:Korean Journal of Anesthesiology
2014;66(6):451-456
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Succinylcholine commonly produces frequent adverse effects, including muscle fasciculation and myalgia. The current study identified the optimal dose of rocuronium to prevent succinylcholine-induced fasciculation and myalgia and evaluated the influence of rocuronium on the speed of onset produced by succinylcholine. METHODS: This randomized, double-blinded study was conducted in 100 patients randomly allocated into five groups of 20 patients each. Patients were randomized to receive 0.02, 0.03, 0.04, 0.05 and 0.06 mg/kg rocuronium as a precurarizing dose. Neuromuscular monitoring after each precurarizing dose was recorded from the adductor pollicis muscle using acceleromyography with train-of-four stimulation of the ulnar nerve. All patients received succinylcholine 1.5 mg/kg at 2 minutes after the precurarization, and were assessed the incidence and severity of fasciculations, while myalgia was assessed at 24 hours after surgery. RESULTS: The incidence and severity of visible muscle fasciculation was significantly less with increasing the amount of precurarizing dose of rocuronium (P < 0.001). Those of myalgia tend to decrease according to increasing the amount of precurarizing dose of rocuronium, but there was no significance (P = 0.072). The onset time of succinylcholine was significantly longer with increasing the amount of precurarizing dose of rocuronium (P < 0.001). CONCLUSIONS: Precurarization with 0.04 mg/kg rocuronium was the optimal dose considering the reduction in the incidence and severity of fasciculation and myalgia with acceptable onset time, and the safe and effective precurarization.
