[Precurarization of succinylcholine with cisatracurium: the influence of the precurarization interval].
OBJECTIVE
To determine the influence of two different pretreatment intervals, i.e. 3 and 6 min, on the efficacy of 0.01 mg/kg cisatracurium in preventing succinylcholine-induced fasciculations and myalgia.


METHODS
A total of 60 adult patients were randomized and received either 0.01 mg/kg cisatracurium (0.2*ED(95)) i.v. (Cis 3 group: pretreatment interval 3 min, Cis 6 group: pretreatment interval 6 min) or normal saline i.v. (placebo group) prior to injection of succinylcholine. The incidence and severity of fasciculations and myalgia and side-effects of precurarization were assessed.


RESULTS
The incidence of muscle fasciculations was only reduced in the Cis 6 group (45%) compared with the Placebo group (85%), p<0.05. Cisatracurium was associated with a higher incidence of paralytic symptoms in both pretreatment groups (Cis 3: 75%, Cis 6: 80%) compared with the Placebo group (30%), p<0.05.


CONCLUSIONS
Cisatracurium is only effective in preventing succinylcholine-induced fasciculations when a longer pretreatment interval, i.e. 6 min instead of 3 min, is chosen. Precurarization led to signs of paralysis in both pretreatment groups in the majority (75-80%) of patients without reducing the incidence or severity of postoperative myalgia.
Mencke
T
T
Klinik für Anästhesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Homburg/Saar, Germany. thomas.mencke@uniklinik-saarland.de
Becker
C
C
Schreiber
J
J
Bolte
M
M
Fuchs-Buder
T
T
D000328:Adult; D000758:Anesthesia; D001279:Atracurium / Q000009:adverse effects*; D005207:Fasciculation / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D010149:Postoperative Pain / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000453:epidemiology; D013390:Succinylcholine; D013997:Time Factors
D009467:Neuromuscular Depolarizing Agents; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D013390:Succinylcholine