thiopental and Fasciculation

The incidence and intensity of muscle fasciculations as well as the occurrence of cardiac arrhythmias following succinylcholine were evaluated in 36 premedicated children (1.0-5.7 years) after intravenous induction with thiopentone or after inhalation induction with isoflurane (3.75 vol-% in 70% nitrous oxide in oxygen). The study was randomized. In the thiopentone group, fasciculations were seen in all children and in the isoflurane group in 5 of 18 children (P < 0.001). The median of the duration of fasciculations was 15 s with a minimum of 5 s and maximum of 36 s (1st quartile 9 s and 3rd quartile 20 s) in the thiopentone group and 0 (0-15) s with a 1st quartile of 0 and a 3rd quartile of 3 s in the isoflurane group (P < 0.001). No cardiac arrhythmias were noted in either group. In conclusion, isoflurane in nitrous oxide inhibits succinylcholine-induced muscle fasciculations in children.

Topics: Anesthesia, Inhalation; Anesthesia, Intravenous; Arrhythmias, Cardiac; Child, Preschool; Fasciculation; Female; Heart Rate; Humans; Infant; Intubation, Intratracheal; Isoflurane; Male; Nitrous Oxide; Succinylcholine; Thiopental; Time Factors

We compared the incidence of postoperative myalgia (POM) and fasciculations when atracurium (ATR) or d-tubocurarine (DTC) was given prior to succinylcholine (SDC) for tracheal intubation in 44 ASA class I or II outpatient females undergoing laparoscopy. The subjects were assigned to one of three groups: group 1 received 0.025 mg/kg ATR; group 2 received 0.05 mg/kg DTC; and group 3 received saline (NS), all in a double-blind manner. Thiopental was administered 1 min and 45 sec after pretreatment in doses adequate to allow control of ventilation. Three minutes after pretreatment, SDC 1.5 mg/kg was given, and fasciculations were recorded on a scale of 0-3. All patients were questioned 1 and 3 days postoperatively about POM, using a scale of 0-3. Fasciculations occurred in 79% of patients given saline, in 46% of those receiving ATR, and in 12% of those given DTC. Eighty-five percent of ATR patients were free of POM on postoperative day 1. The corresponding figures for DTC and NS were 59% and 43%, respectively. Only the difference between ATR and NS achieved statistical significance. On the third postoperative day, POM was rare and there were no significant differences among the groups. We conclude that DTC is a better defasciculant than ATR. DTC was, however, not significantly better than NS in the prevention of POM. The findings suggest that ATR may be the drug choice for the prevention of POM.

Topics: Adolescent; Adult; Atracurium; Clinical Trials as Topic; Double-Blind Method; Fasciculation; Female; Humans; Intubation, Intratracheal; Laparoscopy; Middle Aged; Muscular Diseases; Pain, Postoperative; Random Allocation; Succinylcholine; Thiopental; Tubocurarine

The incidence and severity of muscle pains and changes in creatine kinase were assessed following administration of 1 mg.kg-1 suxamethonium either immediately or 2 min after induction of anaesthesia with propofol or thiopentone in patients undergoing elective dental and ophthalmic surgery. The incidence of muscle pains was 35 and 60% respectively in the groups given suxamethonium immediately and 2 min after propofol, and 35 and 55% when given immediately and 2 min after thiopentone, with no statistically significant differences among the groups. Creatine kinase levels increased in all the groups after operation with the least average increase in the group receiving suxamethonium immediately after propofol and the highest increase in the group receiving suxamethonium 2 min after thiopentone. There was no correlation between the incidence and severity of fasciculations, muscle pains and changes in creatine kinase within or between the groups. It is concluded that neither the induction agent nor the time between the induction agent and suxamethonium administration has any significant influence on the incidence of muscle pains or creatine kinase elevation following suxamethonium.

Topics: Adolescent; Adult; Aged; Anesthesia, Intravenous; Creatine Kinase; Fasciculation; Female; Humans; Male; Middle Aged; Muscular Diseases; Pain; Postoperative Complications; Propofol; Succinylcholine; Thiopental

Topics: Abdominal Muscles; Adult; Aged; Anesthesia, Intravenous; Electromyography; Fasciculation; Humans; Intubation, Gastrointestinal; Male; Middle Aged; Movement Disorders; Pressure; Stomach; Succinylcholine; Thiopental; Tubocurarine

Thiopentone doses corresponding to 5.238 mg x kg-1, that is 2UD95 (UD95:unconsciousness dose 95) inhibit the intensity of succinylcholine-induced fasciculations compared with UD95. Alfathesin doses corresponding to 0.570 mg x kg-1, also 2UD95 (calculated as alphaxalone at a concentration of 9 mg/ml in alfathesin), do not have any greater effect on the degree of fasciculations compared to UD95. Furthermore, neither induction agent influences the incidence, distribution and duration of succinylcholine-induced myalgias. The inhibition of the degree of fasciculations caused by thiopentone is believed to be a consequence of a postsynaptic depressant effect of thiopentone at the neuromuscular junction. The evaluation of the degree of succinylcholine-induced fasciculations must take into consideration the dose of thiopentone administered at induction of anaesthesia.

Topics: Adult; Alfaxalone Alfadolone Mixture; Dose-Response Relationship, Drug; Drug Interactions; Fasciculation; Female; Humans; Middle Aged; Movement Disorders; Muscular Diseases; Postoperative Period; Succinylcholine; Thiopental

Serum potassium concentration during the thiopentone-succinylcholine induction of endotracheal anesthesia was examined in 53 patients undergoing elective surgery. There was no change in serum potassium after thiopentone. During muscle fasciculation serum potassium fell by 0.37 meq/L and returned to the initial level by the end of fasciculation. During muscle relaxation there was a further rise of 0.41 meq/L. The expected increase in serum potassium following the administration of succinylcholine is shown to be preceded by a transient decrease.

Topics: Adolescent; Adult; Aged; Anesthesia, Endotracheal; Fasciculation; Female; Humans; Male; Middle Aged; Muscle Relaxation; Potassium; Succinylcholine; Thiopental

Topics: Adolescent; Adult; Fasciculation; Female; Glaucoma; Humans; Intraocular Pressure; Movement Disorders; Succinylcholine; Thiopental; Time Factors