title: A comparison of tubocurarine, rocuronium, and cisatracurium in the prevention and reduction of succinylcholine-induced muscle fasciculations.
abstract: Fasciculations are a common side effect of the use of succinylcholine for tracheal intubation. Many anesthesia care providers prefer to prevent them due to a possible association between fasciculations and increased intracranial and intraocular pressures. The purpose of this study was to compare the effectiveness of tubocurarine, rocuronium, and cisatracurium in the prevention and reduction of succinylcholine-induced muscle fasciculations. The study was a prospective, randomized, double-blind, clinical drug comparison. We randomly assigned 40 subjects to 1 of 4 pretreatment groups. Fasciculations were graded on a 4-point scale. A Kruskal-Wallis analysis of variance, used to analyze data collected from the fasciculation scale, demonstrated there was no statistically significant difference in efficacy between tubocurarine and rocuronium for defasciculation or between cisatracurium and saline for defasciculation. Significant differences were shown between the tubocurarine and cisatracurium groups and between the rocuronium and cisatracurium groups. Rocuronium is equally as efficacious as tubocurarine for defasciculation. Therefore, rocuronium is a valid alternative to tubocurarine for defasciculation. Cisatracurium is inferior to rocuronium and tubocurarine for defasciculation. Therefore, the use of cisatracurium is not recommended for defasciculation.
authors.affiliation: Brooke Army Medical Center, Fort Sam Houston, Tex., USA.
authors.forename: Cybil A
authors.initials: CA
authors.lastname: True
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Carter
mesh_terms: D000328:Adult; D000732:Androstanols / Q000008:administration & dosage*; D001279:Atracurium / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D005207:Fasciculation / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000009:adverse effects; D009719:Nurse Anesthetists; D011446:Prospective Studies; D000077123:Rocuronium; D013390:Succinylcholine / Q000009:adverse effects; D014403:Tubocurarine / Q000008:administration & dosage*
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; D013390:Succinylcholine; C101584:cisatracurium; D014403:Tubocurarine; D000077123:Rocuronium