Comparison of rocuronium and d-tubocurarine for prevention of succinylcholine-induced fasciculations and myalgia.
OBJECTIVE
We compared d-tubocurarine and rocuronium for the prevention of succinylcholine-induced fasciculations and postoperative myalgia (POM) and evaluated the influence of both drugs on the speed of onset and recovery of succinylcholine.


METHODS
Seventy-five women undergoing surgery of short duration were studied. They were randomized to one of three groups: group SAL received normal saline followed three minutes later by 1.0 mg.kg-1 succinylcholine; group ROC received 0.05 mg.kg-1 rocuronium + 1.5 mg.kg-1 succinylcholine; group DTC received 0.05 mg.kg-1 d-tubocurarine + 1.5 mg.kg-1 succinylcholine. Single-twitch stimulation was applied to the ulnar nerve every 10 sec and the EMG response of the adductor pollicis was recorded. Fasciculations were assessed by a blinded observer on a scale of 0-3. Patients were asked 24 and 48 hr later to rate POM using a scale of 0-10.


RESULTS
The interval needed for twitch height to decrease to 10% of initial value after succinylcholine was longer in group ROC (58 +/- 20 sec) (mean +/- SD) compared with group SAL (44 +/- 13 sec) (P < 0.05). Recovery to 20% occurred faster in group ROC (324 +/- 83 sec) than in groups SAL (456 +/- 103 sec) and DTC (450 +/-132 sec) (P < 0.05). Fasciculations were more intense in groups SAL than in groups ROC and DTC (P < 0.001). Patients rated POM as less intense 24hr postoperatively only in group ROC (1.2 +/- 2.4) compared with group SAL (3.3 +/- 3.5) (P < 0.05).


CONCLUSIONS
Rocuronium prevents succinylcholine-induced fasciculations and POM. Rocuronium also delays the onset of succinylcholine and shortens its duration compared with d-tubocurarine.
Demers-Pelletier
J
J
Department of Anaesthesia, University of Montréal, Maisonneuve-Rosemont Hospital, Québec, Canada.
Drolet
P
P
Girard
M
M
Donati
F
F
D000293:Adolescent; D000328:Adult; D000732:Androstanols; D000768:Anesthesia, General / Q000009:adverse effects; D004558:Electric Stimulation; D004576:Electromyography; D005207:Fasciculation / Q000139:chemically induced* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects; D003473:Neuromuscular Nondepolarizing Agents; D010149:Postoperative Pain / Q000139:chemically induced* / Q000517:prevention & control*; D000077123:Rocuronium; D013390:Succinylcholine / Q000009:adverse effects; D013997:Time Factors; D014403:Tubocurarine
D000732:Androstanols; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D013390:Succinylcholine; D014403:Tubocurarine; D000077123:Rocuronium