EFFECT OF PRETREATMENT WITH MAGNESIUM SULPHATE ON SUCCINYLCHOLINE-INDUCED FASCICULATIONS AND MYALGIA

Abstract

Astha Raman1, Rakesh Kumar Singh2, Fuzail Sarwer3, Rekha Kumari4, Subodha Kumar Mishra5, Arshad Imam6, Ashutosh Kumar Jha7

BACKGROUND
Succinylcholine, a depolarising muscle relaxant possesses a unique property of rapid onset and short duration of action, but is accompanied by side effects such as fasciculations and myalgia. A prospective randomised-controlled trial was designed to assess the effect of a combination of magnesium sulphate with propofol for induction of anaesthesia on succinylcholine-induced fasciculations and myalgia.
MATERIALS AND METHODS
60 adult patients of ASA status I and II of both sexes for elective surgery under general anaesthesia were randomly allocated into two equal groups, group MG and group NS. The patients of MG group were pretreated with magnesium sulphate 40 mg/kg body weight in 10 mL volume, while patients of NS group were given isotonic saline 0.9% in the same volume (10 mL) intravenously slowly over a period of 10 mins. Anaesthesia was administered with pentazocine 0.6 mg/kg and propofol 2 mg/kg, followed by administration of succinylcholine 2 mg/kg intravenously. Muscle fasciculations were observed and graded as nil, mild, moderate or severe. Postoperative myalgia was assessed after 24 hrs. of surgery and graded as nil, mild, moderate or severe. Observations were made in double blind manner where the observer and the patient were blinded.
RESULTS
Demographic data and baseline parameters of both groups were comparable (P>0.05). Muscle fasciculations occurred in 66.7% patients of MG group versus 100% patients of NS group with a significant difference (P<0.001). After 24 hrs. of surgery, 12 patients of MG group and 28 patients of NS group had myalgia with a significant difference (P<0.001). Statistically significant difference was found in MAP and heart rate at various intervals between the two groups (P<0.001).
CONCLUSION
Magnesium sulphate 40 mg/kg intravenously maybe used with propofol for induction of anaesthesia to control succinylcholine-induced fasciculations and myalgia.

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