Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical Study

Introduction: Succinylcholine is the best agent for providing ideal intubating condition. Muscle fasciculation is common after succinylcholine administration and causes postoperative myalgia. Pretreatment with non depolarising muscle relaxant decreases fasciculation and myalgia after succinylcholine...

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Main Authors: Saptadeepa Gupta, Bani Parvati Magda Hembrom, Suchismita Mallick, Arpita Choudhury, Sarmila Ghosh
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2022-09-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://www.jcdr.net/articles/PDF/16938/57399_CE(AnK)_F(SHU)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf
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author Saptadeepa Gupta
Bani Parvati Magda Hembrom
Suchismita Mallick
Arpita Choudhury
Sarmila Ghosh
author_facet Saptadeepa Gupta
Bani Parvati Magda Hembrom
Suchismita Mallick
Arpita Choudhury
Sarmila Ghosh
author_sort Saptadeepa Gupta
collection DOAJ
description Introduction: Succinylcholine is the best agent for providing ideal intubating condition. Muscle fasciculation is common after succinylcholine administration and causes postoperative myalgia. Pretreatment with non depolarising muscle relaxant decreases fasciculation and myalgia after succinylcholine administration. Aim: To compare the efficacy between cisatracurium and rocuronium in preventing succinylcholine induced fasciculation in patients undergoing general anaesthesia and determining association between fasciculation and myalgia after succinylcholine use. Materials and Methods: The present study was a hospital-based, randomised, double-blinded clinical study conducted from January 2020 to July 2020. The study included 64 patients of American Society of Anaesthesiologists (ASA) grade I and II undergoing surgery under general anaesthesia which were randomly allocated in two groups. Group 1 (N=32) received intravenous (i.v.) cisatracurium (0.01 mg/kg) and group 2 (N=32) received i.v. rocuronium (0.06 mg/kg) as precurarising agent, three minutes before i.v. succinylcholine (1.5 mg/kg) administration. Incidence and intensity of fasciculation after succinylcholine injection was observed using a 4 point scale. Haemodynamic parameters were compared by measuring Mean Arterial Pressure (MAP) and Heart Rate (HR) before and after intubation. Patients were followed-up in Postanesthesia Care Unit (PACU) on Postoperative Day 1 (POD1) for myalgia. Observations in two groups were analysed using standard statistical test. Results: Fasciculation was significantly lower in group 2 (mean 0.2187±0.4200) than group 1 (mean 1.125±0.833, p-value <0.001). A significant association was found between fasciculation after succinylcholine injection and postoperative myalgia (p-value=0.007). Group 2 had less incidence of myalgia than group 1. However, the difference was not statistically significant. Conclusion: Rocuronium was more efficacious than cisatracurium in preventing succinylcholine induced fasciculation and rocuronium was more effective in preventing succinylcholine-related postoperative myalgia.
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spelling doaj.art-6dbe3d6636d54392942ef8a0e0da22d52023-01-28T05:27:03ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-09-01169UC52UC5610.7860/JCDR/2022/57399.16938Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical StudySaptadeepa Gupta0Bani Parvati Magda Hembrom1Suchismita Mallick2Arpita Choudhury3Sarmila Ghosh 4Junior Resident, Department of Anaesthesiology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India.Associate Professor, Department of Anaesthesiology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India.Associate Professor, Department of Anaesthesiology, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, India.Assistant Professor, Department of Anaesthesiology, RG Kar Medical College and Hospital, Kolkata, West Bengal, India.Professor, Department of Anaesthesiology, Murshidabad Medical College, Murshidabad, West Bengal, India.Introduction: Succinylcholine is the best agent for providing ideal intubating condition. Muscle fasciculation is common after succinylcholine administration and causes postoperative myalgia. Pretreatment with non depolarising muscle relaxant decreases fasciculation and myalgia after succinylcholine administration. Aim: To compare the efficacy between cisatracurium and rocuronium in preventing succinylcholine induced fasciculation in patients undergoing general anaesthesia and determining association between fasciculation and myalgia after succinylcholine use. Materials and Methods: The present study was a hospital-based, randomised, double-blinded clinical study conducted from January 2020 to July 2020. The study included 64 patients of American Society of Anaesthesiologists (ASA) grade I and II undergoing surgery under general anaesthesia which were randomly allocated in two groups. Group 1 (N=32) received intravenous (i.v.) cisatracurium (0.01 mg/kg) and group 2 (N=32) received i.v. rocuronium (0.06 mg/kg) as precurarising agent, three minutes before i.v. succinylcholine (1.5 mg/kg) administration. Incidence and intensity of fasciculation after succinylcholine injection was observed using a 4 point scale. Haemodynamic parameters were compared by measuring Mean Arterial Pressure (MAP) and Heart Rate (HR) before and after intubation. Patients were followed-up in Postanesthesia Care Unit (PACU) on Postoperative Day 1 (POD1) for myalgia. Observations in two groups were analysed using standard statistical test. Results: Fasciculation was significantly lower in group 2 (mean 0.2187±0.4200) than group 1 (mean 1.125±0.833, p-value <0.001). A significant association was found between fasciculation after succinylcholine injection and postoperative myalgia (p-value=0.007). Group 2 had less incidence of myalgia than group 1. However, the difference was not statistically significant. Conclusion: Rocuronium was more efficacious than cisatracurium in preventing succinylcholine induced fasciculation and rocuronium was more effective in preventing succinylcholine-related postoperative myalgia.https://www.jcdr.net/articles/PDF/16938/57399_CE(AnK)_F(SHU)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdfnon depolarising muscle relaxantprecurarisationpostoperative myalgia
spellingShingle Saptadeepa Gupta
Bani Parvati Magda Hembrom
Suchismita Mallick
Arpita Choudhury
Sarmila Ghosh
Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical Study
Journal of Clinical and Diagnostic Research
non depolarising muscle relaxant
precurarisation
postoperative myalgia
title Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical Study
title_full Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical Study
title_fullStr Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical Study
title_full_unstemmed Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical Study
title_short Comparison of the Effect of Pretreatment with Cisatracurium and Rocuronium on Succinylcholine Induced Fasciculation for Patients undergoing Surgery under General Anaesthesia: A Randomised Clinical Study
title_sort comparison of the effect of pretreatment with cisatracurium and rocuronium on succinylcholine induced fasciculation for patients undergoing surgery under general anaesthesia a randomised clinical study
topic non depolarising muscle relaxant
precurarisation
postoperative myalgia
url https://www.jcdr.net/articles/PDF/16938/57399_CE(AnK)_F(SHU)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf
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