title: Midazolam pretreatment does not ameliorate myoglobinemia or the clinical side effects of succinylcholine.
abstract: OBJECTIVE
  To determine whether the levels of serum myoglobin and the occurrence of fasciculations and postoperative symptoms following a single dose of succinylcholine are modified by the prior administration of midazolam.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Outpatient surgical service of a university hospital.
  
  
  METHODS
  69 ASA physical status I and II healthy, adult female outpatients undergoing laparoscopy (for diagnosis or tubal ligation) with general anesthesia that included succinylcholine.
  
  
  METHODS
  Patients received pretreatment of either a saline placebo (Group 1, n = 31) or intravenous midazolam 0.03 mg/kg (Group 2, n = 38) 5 minutes before succinylcholine.
  
  
  RESULTS
  Serum myoglobin prior to pretreatment and at 5 (t5) and 30 (t30) minutes after succinylcholine was determined by radioimmunoassay. Pain was assessed by telephone interview 24 to 36 hours postoperatively. Baseline myoglobin levels ranged from 14 to 69 ng/ml; the 5- and 30-minute samples varied widely (range, 16 to 900 ng/ml). The rise was 3 or more SDs above the baseline mean in 23% and 42% of Group 1 at t5 and t30, respectively, and in 21% and 35% of Group 2 at t5 and t30, respectively. The differences between groups were not significant. The frequency of fasciculations (77% in Group 1, 87% in Group 2), postoperative sore throat (64% in Group 1, 57% in Group 2), and myalgias (44% in Group 1, 51% in Group 2) also was not significantly different between groups.
  
  
  CONCLUSIONS
  Midazolam had no effect on myoglobin level or postoperative symptoms following succinylcholine.
authors.affiliation: Department of Anesthesiology, University of Maryland, Baltimore.
authors.forename: Q A
authors.initials: QA
authors.lastname: Fisher
authors.forename: E
authors.initials: E
authors.lastname: Fisher
authors.forename: M J
authors.initials: MJ
authors.lastname: Matjasko
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D004311:Double-Blind Method; D005207:Fasciculation / Q000139:chemically induced / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D010535:Laparoscopy; D008874:Midazolam / Q000008:administration & dosage*; D009132:Muscles; D009211:Myoglobin / Q000097:blood*; D010146:Pain / Q000139:chemically induced / Q000517:prevention & control*; D010612:Pharyngitis / Q000139:chemically induced / Q000517:prevention & control*; D011229:Preanesthetic Medication; D013390:Succinylcholine / Q000009:adverse effects*
chemical_list: D009211:Myoglobin; D013390:Succinylcholine; D008874:Midazolam