Abstract
A study was conducted to determine the optimal interval between the administration of d-tubocurarine (dTc) and succinylcholine (SCh) with regard to onset and duration of neuromuscular block and presence of fasciculations and postoperative myalgias.
Forty female patients received dTc 3 mg .70kg-1 prior to SCh 1.5mg.kg-1. The interval between drugs was 0, I, 3, 5, or 7 minutes Transduced thumb adduction recorded block onset and recovery. Fasciculations were visually detected. Myalgias were assessed on postoperative interview.
Pretreatment interval did not affect the onset or recovery of neuromuscuiar block. Postoperative myalgias were also independent of pretreatment timing. Fasciculations were blocked with 3, 5, or 7 minute intervals, but not with Oor I minute intervals. Therefore, three minutes appear to be the optimal, time interval between administration of dTc and SCh since shorter intervals do not inhibit fasciculations and longer intervals do not afford any additional advantages.
Résumé
On a cherché à déterminer I’mtervalle idéal à maintenir entre l’administration préventive de la d-lubocurarine (dTc) et celle de la succinytcholine (SCh), intervalle qui permettruit de conserver la rapidité d’ installation du bloc neuromusculaire et sa durée tout en minimisanl ies fasciculations et Ies myalgies post-opératoires.
L étude a porté sur 40 patientes ayant reçu 3 mg 70 kg-1 de dTc avant I’administration de 1.5 mg-kg-1 SCh. Les patientes ont été réparties en groupes ou l’intervalle entre I’administration des médicaments a été de O, 1, 3, 5, et 7 minutes. La mesure de l’adduction du pouce par transducteur moniwrait I installation et la disparition du bloc neuromusculaire. Les fasciculations etaient observées visuellement et les myalgies évaluées au cours d’une entrevue post-opératoire.
L’installation ou la disparition du bloc neuromusculaire n’est pas influencée par I’intervalle entre les injections non plus que les myalgies post-operatoires. Les fasciculations étaient éliminées pour des intervalles de 3, 5 ou 7 minutes maix encore présentes pour des intervcdles de 0 ou I minute.
Il semble done qu’un intervalle de trot’s minutes entre I administration de dTc et de SCh est souhaitable car des intervalles plus courts ne préviennent pas les fasciculations et des intervalles plus longs n’opponent aucun avantage additionnel.
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References
Baraka A. Self-taming of succinylcholine-induced fasciculations. Anesthesiology 1977; 46:292.
Usubiaga JE, Wikinski JA, Usubiaga LE, Molina F. Intravenous lidocaine in the prevention of postoperative muscle pain by succinylcholinc administration. Anesth Analg 1967; 46:225.
Haldia KN, Chatierji S, Kackar SN. Intravenous lignocaine for prevention of muscle pain after succinylcholine. Anesth Analg 1973; 52:849.
Fahmy NR, Malek NS, Lappas DG. Diazepam prevents some adverse effects of succinylcholine. Clin Pharmacol Ther 1979; 26:395.
Verma RS, Chatterji S, Mathur N. Diazepam and succinylcholine-induced muscle pains. Anesth Analg 1978; 57:295.
Erkola 0, Salmenpera M, Tammisto T. Does diaze- pam pretreatment prevent succinylcholine induced fasciculations? A double-blind comparison of diaze-pam and tubocurarine pretreatments. Anesth Analg 1980; 59:932.
Gupte SR, Savant NS. Post suxamethonium pains and vitamin. Anaesthesia 1971; 26:436.
Cullen DJ. The effect of pretreatment with nonde-polarizing muscle relaxants on the neuromuscular blocking action of succinylcholine. Anesthesiology 1971; 35:572.
Bennett EJ, Montgomery SJ, Dalai FY, Raj PP. Pancuronium and the fasciculations of succinylcholine. Anesth Analg 1973; 52:892.
Domaoai AM, Weniger FC, Wolfson B. “Pre-curarization” using pancuronium. Anesth Analg 1975; 54:71.
Blitt CD, Carlson GL, Rolling GD, Hameroff SR, Otto CW. A comparative evaluation of pretreatment with nondepolarizing neuromuscular blockcrs prior to the administration of succinylcholine. Anesthesiology 1981; 55:687.
Virtue RW. Comparison of gallamine with d-tubo-curarine effects on fasciculations after succinylcholine. Anesth Analg 1975: 54:81.
Hollander H, Wolfe DA. Nonparametric Statistical Methods. New York: Wiley, 1973; 120.
Walts LF, Dillon JB. Clinical studies of the interaction between d-tubocurarine and succinylcholine. Anesthesiology 1969; 31:39.
Miller RD, Way WL. The interaction between succinylcholine and sub-paralyzing doses of d-tubocurarine and gallamine in man. Anesthesiology 1971; 35:567.
Freund FG, Rubin AP. The need for additional succinylcholine after d-tubocurarine. Anesthesiology 1972; 36:185.
Collier CB. Suxamethonium fasciculations: A topographical study.. Anaesth Intensive Care 1980; 8:26.
Brodsky JB, Ehrenwerth J. Postoperative muscle pains and suxamethonium. Br J Anaesth 1980; 52:215.
Crawford JS. Suxamethonium muscle pains and pregnancy. Br J Anaesth 1971; 43:677.
CraigHJL. The protective effect of thiopcnlone against muscular pain and stiffness which follows the use of suxamethonium chloride. Br J Anaesth 1964; 36:612.
Morris DDB, Dunn CH. Suxamethonium chloride administration and post-operative muscle pain. Br Med J 1957; 1:383.
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Horrow, J.C., Lambert, D.H. The search for an optimal interval between pretreatment dose of D-tubocurarine and succinylcholine. Can Anaesth Soc J 31, 528–533 (1984). https://doi.org/10.1007/BF03009538
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DOI: https://doi.org/10.1007/BF03009538