Rocuronium Is the Best Non-Depolarizing Relaxant to Prevent Succinylcholine Fasciculations and Myalgia

ied. They were divided into six groups of 20 according to the non-depolarizing pretreatment used: NaCl 0.9%(control), 0.05 mg'kg -I d-tubocurarine, 0.01 mg'l~ I vecuronium, 0.05 mg'kg -I atracurium, 0.02 mg'kg -I mivacurium and 0.06 mg.kg -I rocuronium. Four minutes after the pretreatment, 1.5 mg.kg -I succinytcholine was injected. Side effects of the pretreatment, the presence and magnitude of fasciculations, the ease of tracheal intubation, myalgia I, 24 and 48 hr after surgery were observed. A Puritan Bennett Datex TM 221 NMT Relaxograph monitor was used to evaluate the neuromuscular block. Results: Muscle fasciculations were observed in 19 of the 20 patients in the control group and in 3 of the 20 patients in the rocuronium group, the best of the pretreatments in that aspect. Four patients in the mivacurium group were unable to sustain more than four seconds head-lift after pretreatment (P < 0.05). Tracheal intubation conditions were better and the onset of block was faster and longer after succinylcholine in the control group (P < 0.05). Myalgias were present in 71% of the patients 24 hr postoperatively and the frequency was not different among the groups. Conclusion: Among the pretreatments tested, 0.06 mg'kg -~ rocuronium was the best to prevent muscular fasciculations following succinylcholine injection. In the population studied, pretreatment did not prevent postoperative myalgia. Succinylcholine 1.5 mg-kg -~ was more effective without a non-depolarizing pretreatment. Objectif : D&erminer quel myorelaxant non d~polarisant, dont la d-tubocurarine, le v&uronium, I'atracurium, le mivacurium et le rocuronium, saura le mieux pr~venir ~les myofasciculations et les myalgies qui suivent I'utilisation de succinylcholine.