Abstract
Purpose
We compared d-tubocuranne and rocuronium for the prevention of succinylcholine-induced fasciculations and postoperative myalgia (POM) and evaluated the influence of both drugs on the speed of onset and recovery of succinylcholine.
Methods
Seventy-five women undergoing surgery of short duration were studied. They were randomized to one of three groups: group SAL received normal saline followed three minutes later by 1.0 mg · kg−1 succinyl-choline: group ROC received 0.05 mg · kg−1 rocuronium + 1.5 mg · kg−1 succinylcholine; group DTC received 0.05 mg · kg−1 d-tubocuranne + 1.5 mg · kg−1 succinylcholine. Single-twitch stimulation was applied to the ulnar nerve every 10 sec and the EMG response of the adductor pollicis was recorded. Fasciculations were assessed by a blinded observer on a scale of 0–3. Patients were asked 24 and 48 hr later to rate POM using a scale of 0–10.
Results
The interval needed for twitch height to decrease to 10% of initial value after succinylcholine was longer in group ROC (58 ± 20 sec) (mean ± SD) compared with group SAL (44 ± 13 sec) (P < 0.05). Recovery to 20% occurred faster in group ROC (324 ± 83 sec) than in groups SAL (456 ± 103 sec) and DTC (450 ±132 sec) (P < 0.05). Fasciculations were more intense in groups SAL than in groups ROC and DTC (P < 0.001). Patients rated POM as less intense 24 hr postoperatrvely only in group ROC (1.2 ± 2.4) compared with group SAL (3.3 ± 3.5) (P < 0.05).
Conclusion
Rocuronium prevents sucinylcholine-induced fasciculations and POM. Rocuronium also delays the onset of succinylcholine and shortens its duration compared with d-tubocuranne.
Résumé
Objectif
Comparer la d-tubocuranne avec le rocuronium sous l’angle de la prévention des fasciculations et de la myalgie postopératoire (MPO) et évaluer l’influence des deux myorelaxants sur la vitesse d’installation et de récupération du bloc neuromusculaire à la succinylcholine.
Méthodes
Soixante-quinze femmes soumises à une chirurgie de courte durée ont participé à l’étude. Elles étaient réparties aléatoirement entre trois groupes: le groupe SAL recevait du sol. phys. suivi trois minutes plus tard de succinylcholine 1.0 mg · kg−1; le groupe ROC, rocuronium 0.05 mg · kg−1 + succinylcholine 1.0 mg · kg−1: le groupe DTC, d-tubocurarine 0.05 mg · kg−1 + succinylcholine 1.5 mg · kg−1. Le nerf cubital était stimulé au twitch simple aux 10 secondes et la réponse EMG de l’adducteur du pouce était enregistrée. Un observateur indépendant évaluait la réponse ÉMG sur une échelle de 0–3. Vingt-quatre et 48 h plus tard, on demandait aux patientes de coter la MPO sur une échelle de 0–10.
Résultats
L’intervalle requis pour abaisser le niveau du twitch à 10% de la valeur initiale après la succinylcholine était plus long dans le groupe ROC (58 ± 20 s; moyenne ± ÉT) comparativement aux groupes SAL (44 ± 13 s) (P < 0.05)). La récupération à 20% survenait plus rapidement dans le groupe ROC (324 ± 83 s) que dans le groupe SAL (456 ± 103 s) et DTC (450 ± 132 s) (P < 0.05). Seules les patientes du groupe ROC évaluaient la MPO comme moins intense 24 h après l’intervention (1.2 ± 2.4) comparativement au groupe SAL (3.3 ± 3.5) (P < 0.05).
Conclusion
Le rocuronium prévient les fasciculations et la MPO induites par la succinylcholine. Comparativement à la d-tubocuranne, le rocuronium retarde aussi le début d’action de la succinylcholine et raccourcit sa durée.
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Demers-Pelletier, J., Drolet, P., Girard, M. et al. Comparison of rocuronium andd-tubocurarine for prevention of succinylcholine-induced fasciculations and myalgia. Can J Anesth 44, 1144–1147 (1997). https://doi.org/10.1007/BF03013334
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DOI: https://doi.org/10.1007/BF03013334