title: Remifentanil attenuates muscle fasciculations by succinylcholine.
abstract: 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.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Mi Ja
authors.initials: MJ
authors.lastname: Yun
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Young Kwon
authors.initials: YK
authors.lastname: Go
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Shin
authors.forename: Choon Gun
authors.initials: CG
authors.lastname: Ryu
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.forename: Nam Jong
authors.initials: NJ
authors.lastname: Paik
authors.forename: Moon Ku
authors.initials: MK
authors.lastname: Han
authors.forename: Sang Hwan
authors.initials: SH
authors.lastname: Do
authors.forename: Woo Suk
authors.initials: WS
authors.lastname: Jung
mesh_terms: 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*
chemical_list: D010880:Piperidines; D003402:Creatine Kinase; D013390:Succinylcholine; D000077208:Remifentanil