Evaluation of succinylcholine-induced fasciculations and myalgias with or without atracurium pretreatment.

Pretreatment regimens that decrease the incidence of fasciculations and postoperative myalgias have been the focus of many research studies. The subject of pretreatment remains controversial. An experimental double blind study was conducted of 50 patients, men and women, aged 18 to 65 years who were having elective minor orthopedic surgery. Group A participants (n = 24) received normal saline, and group B participants (n = 26) received atracurium 0.05 mg/kg, followed by succinylcholine 1.5 mg/kg. Data that were collected included age, ASA physical status, weight, height, anesthesia and postanesthesia recovery times, type of procedure, medications administered, and allergies. Phase I of the study consisted of evaluation for the presence of fasciculations. In phase II, the intubation conditions (e.g., character of the vocal cords, presence of coughing, and degree of ease with laryngoscopy) were evaluated. Phase III included evaluation of postoperative myalgias at 24 and 72 hours. Data were analyzed using measures of central tendency, chi square, Pearson's r and the Student's t test. The incidence of fasciculations was less in the atracurium pretreatment group (group B) than in the group treated with normal saline (group A). Intubation conditions were not compromised by atracurium pretreatment. There was no statistically significant difference between group B and group A in postoperative myalgias. Thus, no recommendations for pretreatment can be made on the basis of this study.