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A COMPARISON OF THE EFFECT OF HIGH DOSE PROPOFOL, STANDARD DOSE PROPOFOL AND SODIUM THIOPENTONE IN THE PREVENTION OF SUXAMETHONIUM INDUCED FASCICULATION AND MYALGIA
ABSTRACT
Background: Suxamethonium is the most commonly used depolarizing neuromuscular agent in clinical practice for rapidly providing ideal conditions for endotracheal intubation.
Its use results in fasciculation and myalgia as part of the potential problems of suxamethonium. These problems have negative impact on the overall medical care of the patients.
Aim: This study was a prospective double blind randomized study designed to compare the efficacy of high dose propofol, 3.5mg/kg with standard dose propofol,2mg/kg and thiopentone sodium, 5mg/kg in reducing the suxamethonium induced fasciculation and myalgia.
Methods: One hundred and five, unpremedicated, ASA l or II, aged between 16 –60 years patients who presented for elective general anaesthesia were recruited. The patients were randomized and induced with either propofol, 2mg/kg (Group P), thiopentone, 5mg/kg (Group STP) or high dose propofol,3.5mg/kg (Group HP). After baseline vital signs were taken, about 500ml of intravenous fluid (normal saline) was given.The induction agents were slowly injected over 90seconds to establish an adequate depth of anaesthesia. Tracheal intubation was facilitated with administration of suxamethonium,1mg/kg. The incidence and severity of fasciculation were recorded.
Anaesthesia was maintained with oxygen/air/isoflurane mixture and pancuronium, 0.1mg/kg was given to facilitate mechanical ventilation. At the end of procedure, residual muscle paralysis was reversed and the trachea was extubated. All patients were assessed with respect to the following : incidence and severity of fasciculation immediately after administration of intravenous suxamethonium, complications during induction, haemodynamic variables, serum creatine phosphokinase (CPK) levels – baseline and 24hours postoperatively as well as theincidence and severity of postoperativemyalgia after 24hours
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