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Prevention of Succinylcholine-induced Fasciculation and Myalgia
Journal article

Prevention of Succinylcholine-induced Fasciculation and Myalgia

  • Schreiber, Jan-Uwe Registrar, Department of Anesthesiology and Critical Care Medicine, University Hospital of the Saarland, Homburg, Germany.
  • Lysakowski, Christopher Staff Anesthesiologist, Division of Anesthesiology, Geneva University Hospitals, Geneva, Switzerland
  • Fuchs-Buder, Thomas Staff Anesthesiologist, Département d'Anesthésie et de Réanimation, Centre Hospitalier Universitaire Nancy/Brabois, Nancy, France.
  • Tramèr, Martin R. Staff Anesthesiologist, Division of Anesthesiology, Geneva University Hospitals, Geneva, Switzerland
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Published in:
  • Anesthesiology. - Ovid Technologies (Wolters Kluwer Health). - 2005, vol. 103, no. 4, p. 877-884
Anesthesiology and Pain Medicine
English Fifty-two randomized trials (5,318 patients) were included in this meta-analysis. In controls, the incidence of fasciculation was 95%, and the incidence of myalgia at 24 h was 50%. Nondepolarizing muscle relaxants, lidocaine, or magnesium prevented fasciculation (number needed to treat, 1.2-2.5). Best prevention of myalgia was with nonsteroidal antiinflammatory drugs (number needed to treat, 2.5) and with rocuronium or lidocaine (number needed to treat, 3). There was a dose-dependent risk of blurred vision, diplopia, voice disorders, and difficulty in breathing and swallowing (number needed to harm, < 3.5) with muscle relaxants. There was evidence of less myalgia with 1.5 mg/kg succinylcholine (compared with 1 mg/kg). Opioids had no impact. Succinylcholine-induced fasciculation may best be prevented with muscle relaxants, lidocaine, or magnesium. Myalgia may best be prevented with muscle relaxants, lidocaine, or nonsteroidal antiinflammatory drugs. The risk of potentially serious adverse events with muscle relaxants is not negligible. Data that allow for a risk-benefit assessment are lacking for other drugs.
Language
  • English
Open access status
closed
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Persistent URL
https://folia.unifr.ch/global/documents/133982
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