A comparison of the effect of two doses of propofol with sodium thiopentone in the prevention of suxamethonium induced fasciculation and myalgia

Background: The use of suxamethonium commonly results in fasciculation and myalgia. This could be distressing to the patient. We compared the efficacy of high dose propofol, 3.5mg/kg with standard dose propofol, 2mg/kg and thiopentone sodium, 5mg/kg in reducing the suxamethonium induced fasciculation and myalgia.Methods: A prospective double blind randomized study in 105 unpremedicated, ASA l or II patients, scheduled for elective general anaesthesia. They were randomized, and induced with propofol, 2mg/kg (Group P), thiopentone, 5mg/kg (Group STP) or high dose propofol, 3.5mg/kg (Group HP). Tracheal intubation was facilitated with IV suxamethonium (1mg/kg). The incidence and severity of fasciculation, 24 hours postoperative myalgia and creatine phosphokinase (CPK) levels were recorded.Results: The incidence (p < 0.001) and severity (p =0.034) of fasciculation was significantly lower in Group HP than Groups P and STP. The incidence (p <0.001), and severity (p =0.010)of myalgia followed a similar trend. The mean 24hours postoperative CPK level was significantly lower in Group HP than Groups P and STP, p <0.001.Conclusion: It is concluded that high dose propofol is more efficient than standard dose propofol and thiopentone in minimizing suxamethonium-induced fasciculation and myalgia. Key Words: suxamethonium, myalgia, fasciculation, creatinine kinase, propofol, sodium thiopentone