COMPARISON OF ROCURONIUM AND D-TUBOCURARINE FOR PREVENTION OF SUCCINYLCHOLINE-INDUCED FASCICULATIONS AND MYALGIA

Purpose: We compared d-tubocurarine and rocuronium for the prevention of succinylcholine-induced fasciculations and postoperative myalgia (P OM) and evaluated the influence of both drugs on the speed of onset an d recovery of succinylcholine. Methods: Seventy-five women undergoing surgery of short duration were studied. They were randomized to one of three groups: group SAL received normal saline followed three minutes later by 1.0 mg.kg(-1) succinylcholine; group ROC received 0.05 mg.kg (-1) rocuronium + 1.5 mg.kg(-1) succinylcholine; group DTC received 0. 05 mg.kg(-1) d-tubocurarine + 1.5 mg.kg(-1) succinylcholine. Single-tw itch stimulation was applied to the ulnar nerve every 10 sec and the E MG response of the adductor pollicis was recorded. Fasciculations were assessed by a blinded observer on a scale of 0-3. Patients were asked 24 and 48 hr later to rate POM using a scale of 0-10. Results: The in terval needed for twitch height to decrease to 10% of initial value af ter succinylcholine was longer in group ROC (58 +/- 20 sec) (mean +/- SD) compared with group SAL (44 +/- 13 sec) (P < 0.05). Recovery to 20 % occurred faster in group ROC (324 +/- 83 sec) than in groups SAL (45 6 +/- 103 sec) and DTC (450 +/- 132 sec) (P < 0.05). Fasciculations we re more intense in groups SAL than in groups ROC and DTC (P < 0.001). Patients rated POM as less intense 24 hr postoperatively only in group ROC (1.2 +/- 2.4) compared with group SAL (3.3 +/- 3.5) (P < 0.05). C onclusion: Rocuronium prevents succinylcholine-induced fasciculations and POM. Rocuronium also delays the onset of succinylcholine and short ens its duration compared with d-tubocurarine.