Yonsei Med J.  2010 Jul;51(4):585-589. 10.3349/ymj.2010.51.4.585.

Remifentanil Attenuates Muscle Fasciculations by Succinylcholine

• Yun MJ
• Kim YH
• Go YK
• Shin JE
• Ryu CG
• Kim W
• Paik NJ
• Han MK
• Do SH
• Jung WS

• KMID: 1805199
• DOI: http://doi.org/10.3349/ymj.2010.51.4.585

Abstract

PURPOSE
The present visual and electromyographic study was designed to evaluate muscle fasciculations caused by succinylcholine in adults pretreated with either remifentanil 1.5 microgram/kg or saline.
MATERIALS AND METHODS
The effect of remifentanil on succinylcholine-induced muscle fasciculations was studied using a double-blind method in 40 adults. After i.v. pretreatment with either remifentanil 1.5 microgram/kg (remifentanil group, n = 20) or an equivalent volume of i.v. saline (saline group, n = 20), patients were anaesthetized with a 2.0 mg/kg of i.v. propofol followed by i.v. succinylcholine 1.0 mg/kg. Intensity and duration of muscle fasciculation following i.v. succinylcholine administration were recorded. Electromyography (EMG) was used to quantify the extent of muscle fasciculation following i.v. succinylcholine injection. Myalgia was evaluated 24 hours after induction time. Serum potassium levels were measured five minutes after i.v. succinylcholine administration and creatine kinase (CK) levels 24 hours after induction time.
RESULTS
Compared to saline treated controls, remifentanil decreased the intensity of muscle fasciculations caused by i.v. succinylcholine [fasciculation severity scores (grade 0 to 3) were 2/1/12/5 and 3/13/4/0 (patients numbers) in the saline group and the remifentanil group, respectively, p < 0.001]. The mean (SD) maximum amplitude of muscle action potential (MAP) by EMG was smaller in the remifentanil group [283.0 (74.4) microV] than in the saline group [1480.4 (161.3) microV] (p = 0.003). Postoperative serum CK levels were lower in the remifentanil group (p < 0.001). Postoperative myalgia was not different between the two groups.
CONCLUSION
Remifentanil 1.5 microgram/kg attenuated intensity of muscle fasciculations by succinylcholine.

Keyword

Fasciculation; remifentanil; succinylcholine

Figure

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  Fig. 1 Typical EMG recordings from the biceps of two patients pretreated with saline or remifentanil. EMG recordings during succinylcholine-induced muscle fasciculation in a patient pretreated with saline (A) or remifentanil (B). Arrows indicate times of i.v. succinylcholine (1.0 mg/kg) administration. Dotted arrow = maximum amplitude. EMG, electromyography.

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