A RAPID PRECURARIZATION TECHNIQUE USING ROCURONIUM

Purpose: To evaluate a rapid and time-saving precurarization technique using rocuronium to prevent succinyl-choline-induced myalgia. Method: In a prospective, double blind randomized study, 42 ASA 1-2 patients were assigned to one of three pretreatment groups: 0.01 ml.kg(-1) norm al saline, 0.1 mg.kg(-1) atracurium, and 0.1 mg.kg(-1) rocuronium. Ana esthesia commenced with 1.5 mu g.kg(-1) fentanyl and 0.5 mg.kg(-1) lid ocaine at time zero. Pretreatment was administered 60 sec later, follo wed by 2.5 mg.kg(-1) propofol. At 90 sec, 1.5 mg.kg(-1) succinylcholin e was injected and 30 sec later the trachea was intubated and the ease of intubation was graded. The patient was observed for the presence a nd severity of fasciculations. Myalgias were recorded on postoperative days 1, 2 and 7. Results: The incidence of fasciculations in the rocu ronium group (21.4%) was lower (P < 0.001) than atracurium (78.5%) or placebo (92.8%) groups. On postoperative day I, the incidence of posto perative myalgia in the rocuronium group (14.2%) was less than-the pla cebo group (78.2%: P < 0.002) and atracurium group (85.7%; P < 0.001). The incidence of myalgia in the rocuronium group (7.1%) was lower tha n in the placebo group (78.5%; P < 0.001) but not different from the a tracurium group (42.8%; P = 0.077) on postoperative day 2. On postoper ative day 7, there was no difference among the three groups. Fascicula tions were related to postoperative myalgia. There was no difference i n intubating conditions among the three groups. Conclusion: Rocuronium pretreatment given just before induction of anaesthesia with propofol reduces fasciculations and succinylcholine-induced myalgia.