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Comparative Studies | Medical Science | India | Volume 12 Issue 8, August 2023 | Rating: 5.4 / 10
Comparative Study: Impact of Propofol and Ketamine Pretreatment on Succinylcholine - Induced Myalgia
Dr. Aakansha Bharat | Dr. Vasanti Sasturkar | Dr. Tulika Newale
Abstract: Background: Succinylcholine is still considered to be the muscle relaxant of choice for performing endotracheal intubation during general anaesthesia. Most common side effect after succinylcholine administration is postoperative myalgia which can cause significant discomfort in patients. Pretreatment with various pharmacological agents have been tried to decrease incidence of myalgia caused after the administration of Succinylcholine with varying success. We conducted the study to compare the effect of pretreatment with Propofol and Ketamine on incidence & severity of Succinylcholine induced postoperative myalgia. Methodology: After obtaining approval from the institutional ethics committee; a prospective, randomized, double blind, study was conducted in ASA Grade I, II male & female patients between age group 18 to 65 years undergoing surgeries of < 3 hours duration under general anaesthesia with endotracheal intubation after succinylcholine administration. Patients were randomly divided into 3 groups of 20 participants each; Group P ? Pretreatment with Propofol (0.5 mg/kg) Group K ? Pretreatment with Ketamine (0.5 mg/kg) Group N ? Pretreatment with Normal Saline as control. During general anaesthesia after induction and succinylcholine administration; occurrence of fasciculations was observed and graded as nil, mild, moderate or severe. The incidence and severity of Succinylcholine induced postoperative myalgia in the patients was determined after 24 hrs& 48 hrs after surgery based on Kararmaz et al?s four point scale as 0, 1, 2 & 3. Statistical analysis: Collected data was analyzed using unpaired t test, one way ANOVA & chi ? square test. Probability value of < 0.05 was considered as statistically significant. Results: The demographic data (age, weight, duration of surgery) of all the 3 groups was comparable (p>0.05). We observed that the incidence & severity of fasciculation was higher in Ketamine group compared to other 2 groups with Propofol group showing least values. The incidence of post operative myalgia was significantly less (10%) at 24 hours in both Propofol and Ketamine group as compared to Normal saline group (50%) (p=0.006). None of the patients complained of moderate or severe grade myalgia in any group. There were no statistically significant changes in heart rate between Propofol and Ketamine groups. Normal saline group showed more increase in heart rate compared to other groups (p<0.05). With respect to MAP, there was statistically significant difference between Propofol, ketamine and normal saline groups with group P showing least & Group N highest values (p < 0.05). Conclusion: Incidence and severity of fasciculation and post operative myalgia is significantly reduced by pretreatment with both Propofol (0.5 mg/kg) and Ketamine (0.5 mg/kg). Although Propofol is more effective in reducing the incidence and severity of fasciculations; both Propofol and Ketamine are equally effective in reducing post - operative myalgia while maintaining haemodynamic stability.
Keywords: Fasciculations, Ketamine, Myalgia, Propofol, Succinylcholine
Edition: Volume 12 Issue 8, August 2023,
Pages: 1037 - 1042