title: Waiting time after non-depolarizing relaxants alter muscle fasciculation response to succinylcholine.
abstract: The purpose of the study was to determine the effect of nondepolarizing muscle relaxants and waiting time on muscle fasciculations after succinylcholine in anaesthetized patients. Adult men and women, 60-80 kg, received pretreatment doses of atracurium 5 mg (n = 160), pancuronium 1 mg (n = 123), d-tubocurarine 3 mg (n = 97), or vecuronium 1 mg (n = 62). Waiting times between pretreatment and succinylcholine, 100 mg, ranged between 0.6 and 5 min. Data points (presence or absence of fasciculations and waiting time) were entered for each patient. Waiting time response curves were obtained between the logit transformation of the probability of no fasciculations and the log waiting time for each drug. Statistical differences between wait time response curves were determined by non-overlapping of the associated 95% confidence intervals. The frequency of muscle fasciculations was reduced with increased waiting time for all nondepolarizers tested. Following wait times of three, four and five minutes, the probability of not fasciculating was greatest with d-tubocurarine (90, 97 and 99%, respectively) and atracurium (89, 93 and 96%). Corresponding values for pancuronium were 70, 82 and 88% and for vecuronium were 74, 82 and 86%. Waiting times to prevent fasciculations in 80% and 90% of patients were shorter with d-tubocurarine (2.46 and 3.02 min, respectively) or atracurium (2.16 and 3.24 min) than pancuronium (3.77 and 5.35 min) or vecuronium (3.73 and 6.36 min).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Anesthesiology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio 44109.
authors.forename: A C
authors.initials: AC
authors.lastname: Pinchak
authors.forename: C E
authors.initials: CE
authors.lastname: Smith
authors.forename: L S
authors.initials: LS
authors.lastname: Shepard
authors.forename: L
authors.initials: L
authors.lastname: Patterson
mesh_terms: D000328:Adult; D001279:Atracurium / Q000008:administration & dosage; D003371:Cough / Q000517:prevention & control; D005207:Fasciculation / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D007442:Intubation, Intratracheal / Q000009:adverse effects; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D010197:Pancuronium / Q000008:administration & dosage; D011229:Preanesthetic Medication; D011446:Prospective Studies; D012737:Sex Factors; D013390:Succinylcholine / Q000009:adverse effects*; D013997:Time Factors; D014403:Tubocurarine / Q000008:administration & dosage; D014673:Vecuronium Bromide / Q000008:administration & dosage
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D014673:Vecuronium Bromide; D013390:Succinylcholine; D010197:Pancuronium; D014403:Tubocurarine