Succinylcholine-induced myalgia in obstetric patients scheduled for caesarean section--diclofenac vs placebo patches.
BACKGROUND
Succinylcholine-induced myalgia is a minor but frequent complication. Its incidence and severity is different according to the studied population. The aim of this study was evaluation of the diclofenac patch effect on postoperative succinylcholine-related myalgia in cesarean section.


METHODS
The study was a prospective randomized double blind, placebo-controlled trial. One hundred twenty six participants undergoing elective cesarean section (previous cesarean section) were randomized in two equal groups (63 participants in each): the diclofenac patch (containing 180 mg of diclofenac epolamine salt) and the placebo. Surgery was performed following rapid sequence induction of general anesthesia. All patients were paralyzed for intubation by succinylcholine (1.5 mg/kg). Data on baseline characteristics, fasciculation, postoperative myalgia (at 12, 24 and 48 hours after operation), the need to analgesic agents, and adverse effects of diclofenac patch were collected.


RESULTS
The basic characteristics were comparable between the two groups. The severity of fasciculation did not significantly vary between two groups. In diclofenac group, the incidences of myalgia at 12, 24 and 48 hours after operation were 23.8%, 19.1%, and 12.7% respectively versus incidences of 52.4%, 47.6%, and 44.4% respectively in placebo group. The incidence and severity of myalgia were significantly lower in patients receiving diclofenac through three evaluation periods (all p values less than 0.01). No participants left the study because of the complications.


CONCLUSIONS
Diclofenac patch is effective and safe in the prevention of postoperative succinylcholine induced myalgia after cesarean section.
Rahimi
Mojgan
M
Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Keshavarz Blvd., Tehran 1419733141, Iran.
Makarem
Jalil
J
Goharrizi
Afshin Goshtasbi
AG
D000279:Administration, Cutaneous; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002585:Cesarean Section; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects*; D010146:Pain / Q000209:etiology*; D010919:Placebos; D011247:Pregnancy; D011446:Prospective Studies; D013390:Succinylcholine / Q000009:adverse effects*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009467:Neuromuscular Depolarizing Agents; D010919:Placebos; D004008:Diclofenac; D013390:Succinylcholine