Remifentanil attenuates muscle fasciculations by succinylcholine.
OBJECTIVE
The present visual and electromyographic study was designed to evaluate muscle fasciculations caused by succinylcholine in adults pretreated with either remifentanil 1.5 microg/kg or saline.


METHODS
The effect of remifentanil on succinylcholine-induced muscle fasciculations was studied using a double-blind method in 40 adults. After i.v. pretreatment with either remifentanil 1.5 microg/kg (remifentanil group, n = 20) or an equivalent volume of i.v. saline (saline group, n = 20), patients were anaesthetized with a 2.0 mg/kg of i.v. propofol followed by i.v. succinylcholine 1.0 mg/kg. Intensity and duration of muscle fasciculation following i.v. succinylcholine administration were recorded. Electromyography (EMG) was used to quantify the extent of muscle fasciculation following i.v. succinylcholine injection. Myalgia was evaluated 24 hours after induction time. Serum potassium levels were measured five minutes after i.v. succinylcholine administration and creatine kinase (CK) levels 24 hours after induction time.


RESULTS
Compared to saline treated controls, remifentanil decreased the intensity of muscle fasciculations caused by i.v. succinylcholine [fasciculation severity scores (grade 0 to 3) were 2/1/12/5 and 3/13/4/0 (patients numbers) in the saline group and the remifentanil group, respectively, p < 0.001]. The mean (SD) maximum amplitude of muscle action potential (MAP) by EMG was smaller in the remifentanil group [283.0 (74.4) microV] than in the saline group [1480.4 (161.3) microV] (p = 0.003). Postoperative serum CK levels were lower in the remifentanil group (p < 0.001). Postoperative myalgia was not different between the two groups.


CONCLUSIONS
Remifentanil 1.5 microg/kg attenuated intensity of muscle fasciculations by succinylcholine.
Yun
Mi Ja
MJ
Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Kim
Yoon Hee
YH
Go
Young Kwon
YK
Shin
Ji Eun
JE
Ryu
Choon Gun
CG
Kim
Won
W
Paik
Nam Jong
NJ
Han
Moon Ku
MK
Do
Sang Hwan
SH
Jung
Woo Suk
WS
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003402:Creatine Kinase / Q000097:blood; D004311:Double-Blind Method; D004576:Electromyography; D005207:Fasciculation / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D013390:Succinylcholine / Q000009:adverse effects*
D010880:Piperidines; D003402:Creatine Kinase; D013390:Succinylcholine; D000077208:Remifentanil