Evaluation of Prophylactic Effect of Intramuscular Diclofenac Sodium for Prevention of Succinylcholine-Induced Myalgia

Abstract

Background: Succinylcholine a depolarizing muscle relaxant with rapid onset, predictable course and short duration of action is associated with myalgia.
 Objectives: To assess the efficacy of intramuscular injection of diclofenac sodium in preventing succinylcholine-induced myalgia.
 Materials and Methods: Eighty healthy adults scheduled for elective surgery under general anesthesia were enrolledin a double-blind study and randomly allocated into two groups of forty patients. Patients in Group I (diclofenacgroup) were pretreated with inj. diclofenac 75 mg deep intramuscularly into gluteal region one hour prior to induction of anesthesia, while patients in Group II (saline group) received an equivalent volume of saline inj. in same site. Anesthesia was induced in both groups with fentanyl 1.5 mcg/kg, propofol 2.0 mg/kg and succinylcholine1.5 mg/kg. Postoperative myalgia was assessed 24 hours after induction and graded as nil, mild, moderate, or severe.
 Results:The demographic data for both groups were comparable (p > 0.05). Postoperative myalgia was recorded at 24 hours after induction in diclofenac group with twelve (30%) patients and 24 (60%) patients in normal saline (control) group respectively (p < 0.05). Conclusion: Prophylactic use of intramuscular injection of diclofenac is effective in the prevention of postoperative myalgia
 KYAMC Journal Vol. 10, No.-1, April 2019, Page 35-38

Prevalence and associated factors of postoperative suxamethonium-induced myalgia in surgical patients at Debre Tabor Comprehensive Specialized Hospital Ethiopia: a cross-sectional study

“…Patients who hadn’t taken premeditations like non-steroidal anti-inflammatory drugs (NSAIDs) were around seven times more likely to develop suxamethonium-induced postoperative myalgia (AOR 7.2; 95% CI 3.2–16.2). This is supported by studies that revealed, that patients premedicated with diclofenac had a significant reduction in the prevalence and intensity of myalgia 16 , 32 , 36 , 39 , 40 . Also, it is supported by another study that showed that pretreatment with oral aspirin and Ketorolac was effective in the reduction of suxamethonium-induced myalgia prevalence 40 , 45 .…”

Intravenous Lidocaine Efficacy in Preventing Succinylcholine-Induced Postoperative Myalgia in Surgical Adult Patients at Tikur Anbessa Specialized Hospital

“…Another proposed mechanism is typically associated with increased levels of serum potassium and myoglobin, leading to enhanced creatine kinase and immediate postoperative muscle pain. [3][4][5] Postoperative myalgia is a prevalent adverse effect of succinylcholine, occurring in 41% to 92% of cases.…”