• G P Joshi, A Hailey, S Cross, G Thompson-Bell, and C C Whitten.
• Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas 75235-9068, USA. girish.joshi@email.swmed.edu
• J Clin Anesth. 1999 Dec 1;11(8):641-5.

Study ObjectiveTo evaluate the efficacy of cisatracurium, rocuronium, and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ambulatory surgery.DesignRandomized, prospective, placebo-controlled trialSettingTeaching hospital.Subjects80 ASA physical status I and II patients scheduled for elective ambulatory surgery with general anesthesia.InterventionA standardized balanced anesthetic technique was used for all patients.Measurements And Main ResultsPatients were randomized to receive cisatracurium 0.01 mg/kg, rocuronium 0.06 mg/kg, d-tubocurarine 0.05 mg/kg, or saline, 3 minutes prior to intravenous (i.v.) succinylcholine 1.5 mg/kg. The intensity of fasciculations and intubating conditions were assessed using a four-point rating scale. In addition, the severity of myalgia was assessed using a four-point rating scale in the postanesthesia care unit and at 24 hours postoperatively. No patient complained of any side effects after the administration of the study drug. Fasciculations were observed less frequently (p < 0.05) in the d-tubocurarine and rocuronium groups compared with the placebo and cisatracurium groups. However, there was no difference between the d-tubocurarine group and the rocuronium group (21% vs. 10%, respectively). Although fasciculations occurred less frequently in the cisatracurium group than in the placebo group (59% vs. 85%, respectively), this difference did not reach statistical significance. There was no difference among the four groups in the intubating conditions or the incidence of postoperative myalgia.ConclusionPretreatment with rocuronium and d-tubocurarine was superior to cisatracurium in preventing succinylcholine-induced fasciculations. However, pretreatment did not have any effect on the incidence of myalgia after ambulatory surgery.

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