Effect of magnesium sulfate with propofol induction of anesthesia on succinylcholine-induced fasciculations and myalgia

Abstract

Background:Magnesium sulfate and propofol have been found to be effective against succinylcholine-induced fasciculations and myalgia, respectively, in separate studies. A prospective randomized double blind controlled study was designed to assess the effect of a combination of magnesium sulfate with propofol for induction of anesthesia on succinylcholine-induced fasciculations and myalgia.Materials and Methods:Randomly selected 60 adult patients scheduled for elective surgery under general anesthesia were allocated to one of the two equal groups by draw of lots. The patients of MG Group were pretreated with magnesium sulfate 40 mg/kg body weight in 10 ml volume, while patients of NS group were given isotonic saline 0.9% in the same volume (10 ml) intravenously slowly over a period of 10 min. Anesthesia was induced with fentanyl 1.5 mcg/kg and propofol 2 mg/kg, followed by administration of succinylcholine 2 mg/kg intravenously. Muscle fasciculations were observed and graded as nil, mild, moderate, or severe. Postoperative myalgia was assessed after 24 h of surgery and graded as nil, mild, moderate, or severe. Observations were made in double blind manner.Results:Demographic data of both groups were comparable (P > 0.05). Muscle fasciculations occurred in 50% patients of MG group versus in 100% patients of NS group with a significant difference (P < 0.001). After 24 h of surgery, no patient of MG group and 30% patients of NS group had myalgia with a significant difference (P < 0.002).Conclusion:Magnesium sulfate 40 mg/kg intravenously may be used with propofol for induction of anesthesia to control succinylcholine-induced fasciculations and myalgia.

Effect of Pretreatment With Magnesium Sulphate on Succinylcholineinduced Fasciculations and Myalgia

“…Our findings are supported by findings of Mahendra Kumar et al (2012) who reported 30% postoperative myalgia in control group compared to none in magnesium sulphate group. 16 Our study is in contrast to the findings of R Ursekar et al (2016) who reported no significant difference in postoperative myalgia between control group and the group receiving magnesium sulphate. 20 Our study is also supported by the study of McClymont C (1994) who found significantly lower incidence of suxamethonium myalgia (19%) compared with thiopentone group (63%) (P<0.05).…”

“…with statistically significant difference between two groups (P<0.001) ( reported fasciculations in 100% of placebo group and 50% in magnesium sulphate group. 16 We observed fasciculations in 66.7% cases in magnesium sulphate group and 100% cases in control group. Our findings are supported by the findings of Sakuraba S et al (2007) who also reported no fasciculations in 33% of magnesium sulphate group.…”

“…The sample size calculated as 28.96 was rounded off to 30 for each group and taken in the study. The patients were randomly allocated into two groups of thirty patients each using a random number table; Group MG who received magnesium sulphate (40 mg/kg body weight in 10 mL water for injection) 16 and Group NS who received isotonic saline (0.9%) in the same volume (10 mL) intravenously slowly over 10 minutes before the induction of anaesthesia. Allocation concealment was done using sealed opaque envelope technique.…”

Comparison of atracurium and methocarbamol for preventing succinylcholine-induced muscle fasciculation: A randomized controlled trial

“…[9] Despite its limitations and side effects, succinylcholine is still a drug of choice for endotracheal intubation in operating rooms. [23] Fasciculation is an adverse effect of succinylcholine that may be a very unpleasant experience for patients.…”

Use of Succinylcholine by Anaesthetists in Turkey: A National Survey

“…Though postoperative myalgia was described at the beginning of the 1950s the pathogenesis is still unclear (37). For prevention a variety of methods, such as low dose of ND-NMBA (37,38), lidocaine (39), magnesium (40), dexmedetomidine (41) and gabapentin (42), have been suggested before administration of SCh. However, postoperative myalgia has still not been completely prevented.…”