Evaluation of Prophylactic Effect of Intramuscular Diclofenac Sodium for Prevention of Succinylcholine-Induced Myalgia

Background: Succinylcholine a depolarizing muscle relaxant with rapid onset, predictable course and short duration of action is associated with myalgia. Objectives: To assess the efficacy of intramuscular injection of diclofenac sodium in preventing succinylcholine-induced myalgia. Materials and Methods: Eighty healthy adults scheduled for elective surgery under general anesthesia were enrolledin a double-blind study and randomly allocated into two groups of forty patients. Patients in Group I (diclofenacgroup) were pretreated with inj. diclofenac 75 mg deep intramuscularly into gluteal region one hour prior to induction of anesthesia, while patients in Group II (saline group) received an equivalent volume of saline inj. in same site. Anesthesia was induced in both groups with fentanyl 1.5 mcg/kg, propofol 2.0 mg/kg and succinylcholine1.5 mg/kg. Postoperative myalgia was assessed 24 hours after induction and graded as nil, mild, moderate, or severe. Results:The demographic data for both groups were comparable (p > 0.05). Postoperative myalgia was recorded at 24 hours after induction in diclofenac group with twelve (30%) patients and 24 (60%) patients in normal saline (control) group respectively (p < 0.05). Conclusion: Prophylactic use of intramuscular injection of diclofenac is effective in the prevention of postoperative myalgia KYAMC Journal Vol. 10, No.-1, April 2019, Page 35-38

[1]  E. Saldanha,et al.  A STUDY OF THE EFFECT OF PRETREATMENT WITH LIDOCAINE AND DICLOFENAC IN REDUCING SUCCINYLCHOLINE INDUCED MYALGIA , 2018 .

[2]  M. Tandon,et al.  Comparative evaluation of prophylactic use of pregabalin, gabapentin and diclofenac sodium for prevention of succinylcholine-induced myalgia: a randomized, double-blinded study. , 2014, Journal of postgraduate medicine.

[3]  C. Pandey,et al.  Prophylactic use of gabapentin for prevention of succinylcholine-induced fasciculation and myalgia: a randomized, double-blinded, placebo-controlled study. , 2012, Journal of postgraduate medicine.

[4]  E. Stuth,et al.  Succinylcholine use in adult anesthesia - A multinational questionnaire survey. , 2011, Collegium antropologicum.

[5]  L. Connolly,et al.  Rapid Sequence Induction and Intubation: Current Controversy , 2010, Anesthesia and analgesia.

[6]  Chingmuh Lee,et al.  Clinical implications of new neuromuscular concepts and agents: so long, neostigmine! So long, sux! , 2009, Journal of critical care.

[7]  S. Kaya,et al.  Effects of high‐dose propofol on succinylcholine‐induced fasciculations and myalgia , 2003, Acta anaesthesiologica Scandinavica.

[8]  T. Fuchs-Buder,et al.  Pretreatment Before Succinylcholine for Outpatient Anesthesia? , 2002, Anesthesia and analgesia.

[9]  F. Chung,et al.  Succinylcholine‐associated postoperative myalgia , 2000, Anaesthesia.

[10]  F. Donati,et al.  Comparison of rocuronium andd-tubocurarine for prevention of succinylcholine-induced fasciculations and myalgia , 1997, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[11]  S. Raman,et al.  Fasciculations, myalgia and biochemical changes following succinylcholine with atracurium and lidocaine pretreatment , 1997, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[12]  G. Hobbs,et al.  Use of ketorolac in the prevention of suxamethonium myalgia. , 1994, British journal of anaesthesia.

[13]  C. McClymont A Comparison of the Effect of Propofol or Thiopentone on the Incidence and Severity of Suxamethonium-Induced Myalgia , 1994, Anaesthesia and intensive care.

[14]  U. Aypar,et al.  Effect of preoperative i.m. administration of diclofenac on suxamethonium-induced myalgia. , 1993, British journal of anaesthesia.

[15]  P. White,et al.  Muscle pain after outpatient laparoscopy--influence of propofol versus thiopental and enflurane. , 1993, Anesthesia and analgesia.

[16]  J. Howe,et al.  Suxamethonium induced myalgia and the effect of pre‐operative administration of oral aspirin , 1988, Anaesthesia.

[17]  G. Larijani,et al.  Comparison of atracurium and d-tubocurarine for prevention of succinylcholine myalgia. , 1987, Anesthesia and analgesia.

[18]  R. Cork,et al.  Succinylcholine Pretreatment with Magnesium Sulfate , 1986, Anesthesia and analgesia.

[19]  D. Jones,et al.  Experimental skeletal muscle damage: the nature of the calcium‐activated degenerative processes , 1984, European journal of clinical investigation.

[20]  R. Mirakhur,et al.  PRETREATMENT WITH VECURONIUM AS A PROPHYLACTIC AGAINST POST-SUXAMETHONIUM MUSCLE PAIN Comparison with other non-depolarizing neuromuscular blocking drugs , 1983 .

[21]  O. Shrivastava,et al.  Calcium Gluconate Pretreatment for Prevention of Succinylcholine‐Induced Myalgia , 1983, Anesthesia and analgesia.

[22]  F. Leonard Diazepam prevents some adverse effects of succinylcholine: Fahmy NR, Malik NS, Lappas DG, Clin Pharmacol Ther 26:395–398, (Sep) 1979 , 1980 .

[23]  C. Collier Suxamethonium pains and early electrolyte changes , 1978, Anaesthesia.