Usefulness of Propofol to Prevent Succinylcholine Induced Fasciculations and Myalgia, a Comparison with Thiopentone Sodium as an Induction Agent

Background: Succinylcholine induced fasciculations and myalgia may be a source of greater distress to the patient than the surgical pain. Aims & Objective: This study was designed to see if propofol offered any protection against succinylcholine induced fasciculations and myalgia compared with thiopentone sodium. Material and Methods: This prospective, randomized study was conducted in a teaching and tertiary care hospital. The study included 99 adult patients scheduled to undergo general anaesthesia for elective surgery. The patients were allocated randomly and equally into Group P1, P2 and T. Anaesthesia was induced in group P1 with propofol 2.5 mg/kg, group P2 with propofol 3.5 mg/kg and group T with thiopentone sodium 5 mg/kg. Tracheal intubation was facilitated by administration of intravenous succinylcholine 2 mg/kg. Incidence and severity of fasciculations were recorded. Anaesthesia was maintained with 50% Nitrous oxide in oxygen, Isoflurane and Vecuronium bromide. At the end of surgery, neuromuscular blockage is reversed and patients were extubated. All the patients were assessed at 6, 12 and 24 hours postoperatively to evaluate the incidence and severity of myalgia. Anova test was applied for quantitative data and Chi-square test for qualitative data. P value < 0.05 was taken as significant. Results: The demographic data of patients of the three groups were comparable. The total incidence of fasciculations were 25(75.76%), 16(48.48%) and 26(78.79%) in group P1, P2 and T respectively (p<0.001). Total score of fasciculations was 44(44.44%), 22(22.22%) and 53(53.54%) in group P1, P2 and T respectively. The severity of fasciculations was reduced more in group P2 than group P1 and T (p=0.0006). The total incidence of myalgia were 19(57.57%), 10(30.3%) and 23(69.7%) in group P1, P2 and T respectively (p<0.001). Total score of myalgia was 35(35.35), 18(18.18) and 45 (45.45) in group P1, P2 and T respectively. The severity of myalgia was reduced more in group P2 than group P1 and T (p<0.001). There was no correlation between fasciculations and myalgia in the present study (Pearson’s r correlation, r = 0.139). Conclusion: Propofol 3.5 mg/kg in comparison with propofol 2.5 mg/kg and thiopentone sodium 5 mg/kg is effective in reducing the incidence and severity of succinylcholine induced fasciculations and myalgia. KEY-WORDS: Succinylcholine; Fasciculations; Myalgia; Propofol; Thiopentone