thiopental and Muscular-Diseases

We conducted a prospective, randomised single-blind study in 48 adult women undergoing laparoscopic gynaecological surgery to assess the incidence of suxamethonium-induced myalgia. Anaesthesia was induced with either thiopentone or propofol. All other aspects of clinical care were standardised between the groups. The propofol group had a significantly lower incidence of suxamethonium myalgia (19%) compared with the thiopentone group (63%) (P < 0.05). The mechanism of this effect is not understood.

Topics: Adolescent; Adult; Anesthesia, Intravenous; Female; Genitalia, Female; Humans; Incidence; Laparoscopy; Middle Aged; Muscular Diseases; Pain; Pain Measurement; Propofol; Prospective Studies; Single-Blind Method; Succinylcholine; Thiopental

A double-blind study was conducted in 52 patients who received a total of 180 electroconvulsive therapy treatments. Patients were allocated randomly to receive doses of 15 mg, 25 mg or 50 mg of suxamethonium. Those who received suxamethonium 50 mg took significantly longer to breathe again compared with patients who received the lower doses, and were significantly more likely to have a very well modified convulsion than patients who received suxamethonium 15 mg. There were no differences among the groups in the incidences of muscle pains after treatment. We conclude that all three doses were acceptable; however, a dose of 25 mg had practical advantages over 50 mg and theoretical advantages over 15 mg.

Topics: Adult; Aged; Dose-Response Relationship, Drug; Electroconvulsive Therapy; Female; Humans; Male; Middle Aged; Muscular Diseases; Pain; Random Allocation; Respiration; 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

Topics: Adult; Anesthesia, Intravenous; Humans; Male; Middle Aged; Muscular Diseases; Pain; Succinylcholine; Thiopental

The incidence and severity of muscle pains were investigated in patients who had been given suxamethonium and thiopentone anesthesia for bronchoscopy. Group I patients received no other drugs. Groups II and III received d-tubocurarine and THA respectively before suxamethonium. Administration of these drugs resulted in a highly significant reduction in the incidence of severe and moderate pains. The use of d-tubocurarine necessitated a significantly greater amount of suxamethonium to maintain paralysis.

Topics: Acridines; Amines; Bronchoscopy; Clinical Trials as Topic; Humans; Middle Aged; Muscular Diseases; Pain, Postoperative; Succinylcholine; Thiopental; Tubocurarine

Topics: Adult; Age Factors; Apnea; Female; Humans; Male; Middle Aged; Muscular Diseases; Pain; Propanidid; Sex Factors; Succinylcholine; Thiopental

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

Nemaline rod myopathy is an inherited congenital myopathy first described in 1963. Affected patients characteristically present in infancy with a non-progressive hypotonia and symmetrical muscle weakness. The disease affects all skeletal muscles including the diaphragm with sparing of cardiac and other muscle. Facial dysmorphism is common as are skeletal deformities, including kyphosis, scoliosis and pectus excavatum. We present two sisters with nemaline rod myopathy and their anaesthetic management for scoliosis surgery. Facial dysmorphism was a feature of both cases. Preoperatively, both patients demonstrated poor respiratory function on pulmonary function testing. Both cases were successfully managed using controlled ventilation and inhalational anaesthetic agents, avoiding muscle relaxants. Postoperatively, there were no respiratory complications. Although one case report describes the use of succinylcholine and pancuronium in a patient with nemaline rod myopathy, we feel that neuromuscular blocking agents should be avoided where possible and only used with careful monitoring.

Topics: Adolescent; Anesthesia, General; Atropine; Female; Halothane; Humans; Muscular Diseases; Nitrous Oxide; Scoliosis; Thiopental

The effects of calcium gluconate pretreatment on succinylcholine-induced postoperative muscle pain and on the changes in serum potassium and calcium levels were studied in 80 patients undergoing elective surgery who were to become ambulatory on the same evening. A test group of 40 patients was given 10 ml of 10% calcium gluconate intravenously immediately before induction of anesthesia with thiopental followed by succinylcholine for tracheal intubation. A control group of 40 patients was given thiopental and succinylcholine without calcium gluconate. Muscle pains were graded according to severity as nil, mild, moderate, and severe. The incidence of postoperative muscle pains was significantly less (5%) in the test group than in the control group (45%). In control patients who subsequently developed muscle pain, serum levels of potassium were significantly increased above preinduction levels 2 min after succinylcholine was administered and serum calcium levels were significantly decreased. In control patients who did not develop postoperative myalgia, there were no significant changes in serum levels of either calcium or potassium. This was also true for patients pretreated with calcium gluconate. Therefore, calcium gluconate pretreatment reduces both the increase in serum potassium and the decrease in serum calcium associated with succinylcholine, and decreases the incidence and severity of postoperative myalgia.

Topics: Adolescent; Adult; Calcium; Calcium Gluconate; Female; Gluconates; Humans; Male; Middle Aged; Muscular Diseases; Pain, Postoperative; Potassium; Premedication; Succinylcholine; Thiopental

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

Topics: Alfaxalone Alfadolone Mixture; Anesthetics; Animals; Bradycardia; Diazepam; Dogs; Femoral Artery; Hypotension; Injections, Intra-Arterial; Muscular Diseases; Shock; Thiopental; Vascular Diseases

Topics: Humans; Injections, Intradermal; Injections, Intravenous; Muscular Diseases; Necrosis; Nervous System Diseases; Paralysis; Skin Ulcer; Tendons; Thiopental

Topics: Acidosis; Adolescent; Alkaline Phosphatase; Anesthesia, Inhalation; Anesthetics; Appendectomy; Aspartate Aminotransferases; Basal Metabolism; Clinical Enzyme Tests; Creatine Kinase; Fever; Halothane; Hernia, Inguinal; Humans; Hypercapnia; L-Lactate Dehydrogenase; Liver; Male; Muscular Diseases; Nitrous Oxide; Pneumothorax; Succinylcholine; Thiopental

Topics: Adult; Electric Stimulation; Electromyography; Humans; Male; Motor Neurons; Muscular Diseases; Myofibrils; Nerve Endings; Neural Conduction; Phenobarbital; Phenytoin; Procaine; Succinylcholine; Thiopental

Topics: Animals; Barbiturates; Blood Flow Velocity; Dogs; Gangrene; Injections, Intra-Arterial; Injections, Intravenous; Muscular Diseases; Neuroleptanalgesia; Thiopental; Vascular Resistance

Topics: Adult; Barbiturates; Bronchoscopy; Humans; Injections, Intramuscular; Injections, Intravenous; Male; Middle Aged; Muscle Proteins; Muscles; Muscular Diseases; Neostigmine; Pain; Postoperative Complications; Potassium; Succinylcholine; Thiopental; Tubocurarine

Topics: Adult; Aged; Anesthesia, Intravenous; Female; Gangrene; Humans; Iatrogenic Disease; Injections, Intravenous; Male; Middle Aged; Muscular Diseases; Necrosis; Nerve Tissue; Peripheral Nervous System Diseases; Thiopental

Topics: Anesthetics; Animals; Female; Femoral Artery; Injections, Intra-Arterial; Muscles; Muscular Diseases; Necrosis; Rats; Thiopental