No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Lignocaine pretreatment for suxamethonium. A clinicobiochemical study
Abstract
Lignocaine pretreatment (2 mg/kg) significantly restricted the increase in serum potassium and decrease in serum calcium caused by suxamethonium. Suxamethonium muscle pains occurred in only 8% of patients who received lignocaine just before induction of anaesthesia. The incidence of muscle pains was 45% in those patients who were not given lignocaine.
... Our study showed an incidence of pain in lidocaine, diclofenac and control groups as 45%,85%and 77.5% respectively. e incidence of myalgia is least in the lidocaine group comparable to studies by ( (3) et al., reported an incidence of 8% in patients receiving lidocaine, lower than the incidence (45%) in our study. ...
... Lidocaine pretreatment has been noted to have a favorable effect on postoperative myalgia and has been used effectively for its (3,8,9) prevention. e lidocaine group in our study had the least intensity of pain as compared to the control and diclofenac groups at all the three time points of study. ...
after approval by the institutional ethical committee. 120 in-patients were selected for the study using purposive sampling after obtaining consent. Inclusion criteria Ÿ Adult ASA I and II physical status of either sex Ÿ Age between 18 and 50 years Ÿ Weight-40 to 65 kg Ÿ Posted for elective minor surgeries Exclusion criteria Ÿ Major surgeries Ÿ Pregnant and lactating women Ÿ Neuromuscular disorders Ÿ Emergency surgical procedures Ÿ Age below 18 years or above 50 years Ÿ Patient refusal Ÿ True allergy to lidocaine and diclofenac All patients were subjected to pre anaesthetic evaluation on the day prior to surgery. Routine pre-operative investigations were done. All patients were kept nil per oral for 8 hours with pre medication of Tab Ranitidine 150 mg orally 12 hours before surgery. Patients were divided into three groups of 40 each, based on random number generated by computer software and pretreatment was given accordingly. In the operating room, baseline SpO2, heart rate and ECG were recorded. Intravenous access was secured. Inj. fentanyl 2 µg/kg IV was given 5 minutes before induction of anaesthesia. Patients were pre-oxygenated and induced with 5 mg/kg IV thiopentone sodium followed by 1.5 mg/kg of succinycholine given IV. Tracheal intubation was performed once the fasciculations reached the toes. Anaesthesia was maintained with nitrous oxide 66% in oxygen and isofluorane 0.6%. Loading dose of 0.1 mg/kg vecuronium was given IV followed by maintenance dose of 0.02 mg/kg every 20 minutes IV. Neuromuscular blockade was reversed with IV neostigmine 0.05 mg/kg and 0.01 mg/kg IV glycopyrrolate at the end of the procedure. Standardized post operative care was given to all the participants. Pain related to the surgical procedure was treated with IV pethidine in a dose of 1mg/kg. Severity and intensity of post operative myalgia was assessed by the investigator with a standardized questionnaire 1hour, 24 hours and 48 hours after surgery.
... Pandey AK et al 17 found in their study, POM was present in 45% in lignocaine group and 77.5% in saline group, severity was also lower in lignocaine group. Chatterji et al 18 reported in their study, POM was present in 8% in lignocaine group. Our study result is in between these two study groups. ...
Succinylcholine, a depolarizing muscle relaxant possesses a unique property of rapid onset and short duration of action, but is accompanied by side effects such as fasciculation and myalgia. The aim of this study was to investigate the prophylactic effect of intravenous lignocaine on the incidence and severity of succinylcholine-induced postoperative myalgia. This was a randomized controlled double blind study conducted at National Institute of ENT Dhaka, during September to December 2017. Eighty adult patients of American Society of Anesthesiologists status I and II of both sexes for elective surgery under general anesthesia were randomly allocated into two equal groups, lignocaine group and normal saline group. The patients of lignocaine group were pretreated with lignocaine 1.5 mg/kg body weight in 5 ml volume, while patients of normal saline group were given isotonic saline 0.9% in the same volume (5 ml) intravenously. Thereafter, anesthesia was induced in all patients, by injecting 1.5 mg/kg of fentanyl and 2 mg/kg of propofol intravenously. Following the loss of eyelid reflex, 1.5 mg/kg of succinylcholine was injected intravenously as a muscle relaxant and then the patients were intubated. The incidence and severity of myalgia were assessed by a blinded observer 24 hours after surgery. In terms of demographic data, the results of this study showed that there is no significant difference between patients in both groups (P>0.05). Overall, the incidence and severity of succinylcholine-induced myalgia in lignocaine group was significantly less, when compared with normal saline group (P<0.05). Pretreatment with intravenous lignocaine is effective in prevention of postoperative succinylcholine induced myalgia. Faridpur Med. Coll. J. Jan 2019;14(1): 13-15
... Since it has been postulated that calcium influx enhances the intensity of muscle fiber contractions, inducing spindle damage and subsequent pain, pre-treatment with medications such as dantrolene which interfere with intracellular calcium release have been reported to be effective [24]. It has also been demonstrated that pre-treatment with calcium gluconate and lidocaine, which provide membrane stabilizing actions, are protective [25,26]. Comparative studies between the inductions of anesthesia with propofol versus thiopental have shown a decreased association of myalgias after induction with propofol [27]. ...
... In one study, it was shown that lignocaine pretreatment restricted the increase in serum potassium and the decrease in serum calcium. This effect of lignocaine was attributed to its cell membrane stabilising properties, which probably prevented ionic exchange across the cell membrane [50]. ...
The subject of postoperative myalgia associated with the use of succinylcholine is reviewed. We discuss the mechanisms of succinylcholine-induced myalgia and the techniques available to prevent and treat the myalgia. In situations where patients are at risk of developing myalgia and succinylcholine is the neuromuscular blocker of choice, the use of a combination of techniques may prove to be a useful strategy.
Severe life-threatening hyperkalaemia may occur following administration of suxamethonium during certain periods after burns, neurological injuries, and in certain other conditions. Although this response is well-known, there is disagreement about when it may occur. This review describes the normal hyperkalaemic response to suxamethonium, the factors affecting it, the conditions in which it may be exaggerated, and the periods of high risk.
Forty patients were investigated for serum myoglobin changes following induction of anaesthesia but before the commencement of surgery. Blood was drawn for potassium, creatinine kinase and serum myoglobin immediately prior to and 5, 10 and 20 minutes after administration of thiopentone 4 mg/kg and suxamethonium 1.2 mg/kg. Twenty patients were given either 2 mg alcuronium or 20 mg gallamine as pretreatment 2 to 3 minutes before the suxamethonium to reduce the fasciculations. Anaesthesia was maintained with artificial ventilation and alcuronium, or spontaneous ventilation with halothane. Serum myoglobin was assayed by radioimmunoassay.
All pre-induction rnyoglobin levels were within the normal range. Of the 20 patients who were not pretreated, six showed a marked rise of serum myoglobin within 5 minutes, increasing to 150–200 μg/litre at 20 minutes. The remaining 14 patients had no such rise. No patients in the pretreatment group had any significant rise in serum myoglobin, suggesting that although the fasciculations were not completely abolished, there was protection against one of the effects of suxamethonium on the muscle. Although there was no clear relationship between intensity of fasciculations and increase in serum myoglobin, there was no marked rise in serum myoglobin values in any patient who did not have muscle fasciculations. There were no consistent changes in potassium or creatinine kinase in any group during the period of study.
The administration of succinylcholine causes an increase in serum potassium (K+) concentrations in healthy patients. The purpose of this study was to investigate serum K+ changes following intravenous succinylcholine in children and to evaluate the effect of rectal midazolam pretreatment on these changes. Forty healthy children between the ages of 2 and 7 yr, and who were to undergo oral surgical procedures under general anesthesia were randomly assigned to receive either placebo (saline) or 0.25, 0.35, or 0.45 mg/kg midazolam administered rectally as premedication 30 min before induction of inhalational anesthesia. Blood was drawn after induction with enflurane and at 1, 2, 3, 4, and 5 min after administration of 1 mg/kg succinylcholine to determine changes in serum K+. Although the results indicate a significant increase in serum K+ after succinylcholine in all groups, midazolam pretreatment failed to cause any observable attenuation in the hyperkalemic response.
Despite its many disadvantages, succinylcholine is the most commonly used drug for intubation of patients for short out-patient procedure. This double blind trial compared a low dose atracurium/lidocaine combination to succinylcholine for intubation in 40 ASA1 adult patients. Low dose atracurium/lidocaine provided clinical intubating conditions at two minutes and cardiovascular stability equivalent to succinylcholine with significantly less myalgia. Spontaneous respiration was slower after low dose atracurium/lidocaine relative to succinylcholine. Low dose atracurium/lidocaine may provide an acceptable alternative to succinylcholine for intubation in short outpatient procedures.
The effectiveness of four pretreatment regimens in decreasing succinylcholine-induced myalgias was studied in healthy outpatients undergoing general anaesthesia for ambulatory surgery. Four hundred and forty adult females were randomly assigned to one of four pretreatment groups. Three hundred and ninety-five patients completed the study. One of the following pretreatments was given prior to injection of 1.5 mg X kg-1 of succinylcholine: normal saline IV three minutes and again immediately prior to succinylcholine; 0.06 mg X kg-1 d-tubo-curarine (dTc) IV three minutes prior and normal saline IV immediately prior; normal saline IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior; 0.06 mg X kg-1 dTc IV three minutes prior and 1.5 mg X kg-1 lidocaine IV immediately prior. Fasciculations after injection of succinylcholine were observed and recorded. Patients were contacted by telephone 40-48 hours postoperatively and questioned about the presence of muscle pains. These pains, if present, were graded either mild or moderate to severe. The patients in the two dTc-containing groups exhibited less fasciculations than patients in the other two experimental groups. The dTc-lidocaine group had a lower incidence of moderate to severe fasciculations than in any of the other three groups. Patients in the dTc, lidocaine, and dTc-lidocaine experimental groups reported a higher incidence of absence of muscle pain and a lower incidence of moderate-severe pain than did patients in the saline group. The dTc-lidocaine group had more patients without myalgia and less patients with moderate to severe myalgias than any of the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)
One hundred gynaecological patients for laparoscopy divided into five groups were studied to determine the effects of a number of pretreatments on serum myoglobin, creatinine kinase and myalgia following intermittent suxamethonium administration. One group acted as controls, while the other groups were given intravenous pretreatments of alcuronium 2 mg, midazolam 0.15 mg/kg, lignocaine 1.5 mg/kg and suxamethonium 7 mg. Serum myoglobin was determined by radio-immunoassay. The mean increases in the control group were 167 micrograms/litre myoglobin at 20 minutes and 196 IU creatinine kinase at 24 hours; 13 out of 20 patients responded with a marked increase of serum myoglobin at 20 minutes and of creatinine kinase at 24 hours. Only alcuronium pretreatment prevented myoglobin increase at 20 minutes, abolished creatinine kinase increase at 24 hours and reduced 24-hour myalgia. The other pretreatments slightly reduced myoglobin increase at 20 minutes and 24-hour creatinine kinase but did not reduce myalgia. Only one patient in the whole study had markedly elevated serum myoglobin at 24 hours. We conclude that only non-depolarising relaxant pretreatment is effective in the reduction of some of the adverse effects of suxamethonium administration.
Muscle relaxants block neuromuscular transmission, acting at nicotinic acetylcholine receptors of the neuromuscular junction. Suxamethonium (succinylcholine) is a depolarising agent, whereas all other relaxants in clinical use are nondepolarising. The desired neuromuscular block results from the structural similarity of muscle relaxants to acetylcholine, enabling the interaction with receptors at the neuromuscular junction. Adverse effects of suxamethonium are generally related to its agonist mode of action. Autonomic cardiovascular effects may result. Other adverse effects include anaphylactic or anaphylactoid reactions, and histamine release. Various disease states may present specific considerations in the use of muscle relaxants. Although many complications of muscle relaxants (such as prolonged block or resistance) are easily treated, others may require immediate intervention and vigorous therapy. Careful selection of appropriate relaxants for particular patients will usually prevent the occurrence of complications.
Shortly after the introduction of the depolarizing neuromuscular blocking agent succinylcholine (SCH), in 1951, I it became apparent that there were a number of problems associated with its use. Bourne et al. 2 described "diffuse uncoordinated contractions" after intravenous administration, noted it could "give rise to a feeling of muscular stiffness," and stated "In a conscious volunteer those contractions were painful." However, it was left to Churchill-Davidson 3 to describe fully the syndrome of postoperative myalgias (POM) and to attempt to reduce the incidence of POM by abolishing the visible muscle fasciculations (with gallamine). In the more than 40 yr since those efforts, dozens of investigations have been published with the intent of finding ways of reducing the incidence of visible fasciculations and POM. It has become common clinical practice to administer a small dose of a non-depolarizing neuromuscular blocking agent
We conducted a prospective, randomised single-blind study in 48 adult women undergoing laparoscopic gynaecological surgery to assess the incidence of suxamethonium-induced myalgia. Anaesthesia was induced with either thiopentone or propofol. All other aspects of clinical care were standardised between the groups. The propofol group had a significantly lower incidence of suxamethonium myalgia (19%) compared with the thiopentone group (63%) (P < 0.05). The mechanism of this effect is not understood.
To determine whether the levels of serum myoglobin and the occurrence of fasciculations and postoperative symptoms following a single dose of succinylcholine are modified by the prior administration of midazolam.
Randomized, double-blind, placebo-controlled study.
Outpatient surgical service of a university hospital.
69 ASA physical status I and II healthy, adult female outpatients undergoing laparoscopy (for diagnosis or tubal ligation) with general anesthesia that included succinylcholine.
Patients received pretreatment of either a saline placebo (Group 1, n = 31) or intravenous midazolam 0.03 mg/kg (Group 2, n = 38) 5 minutes before succinylcholine.
Serum myoglobin prior to pretreatment and at 5 (t5) and 30 (t30) minutes after succinylcholine was determined by radioimmunoassay. Pain was assessed by telephone interview 24 to 36 hours postoperatively. Baseline myoglobin levels ranged from 14 to 69 ng/ml; the 5- and 30-minute samples varied widely (range, 16 to 900 ng/ml). The rise was 3 or more SDs above the baseline mean in 23% and 42% of Group 1 at t5 and t30, respectively, and in 21% and 35% of Group 2 at t5 and t30, respectively. The differences between groups were not significant. The frequency of fasciculations (77% in Group 1, 87% in Group 2), postoperative sore throat (64% in Group 1, 57% in Group 2), and myalgias (44% in Group 1, 51% in Group 2) also was not significantly different between groups.
Midazolam had no effect on myoglobin level or postoperative symptoms following succinylcholine.
To determine the effect of propofol without succinylcholine on intubating conditions and postoperative myalgias in ambulatory surgical patients undergoing general anesthesia.
Prospective, double-blind, randomized study.
Ambulatory surgery adult patients.
56 ASA physical status I and II adult patients undergoing general endotracheal anesthesia.
Group 1 patients received thiamylal plus succinylcholine, Group 2 patients received propofol plus succinylcholine; and Group 3 patients received propofol plus saline. All patients received fentanyl, lidocaine, and nitrous oxide plus isoflurane in oxygen.
Incidence and severity of fasciculations, tracheal intubating conditions, and myalgias on the first and third postoperative days were measured. Propofol did not affect the incidence or severity of fasciculations following succinylcholine, or the incidence of myalgias. Of patients who received propofol without succinylcholine, intubation was successful in 85%.
Propofol did not affect the incidence or severity of postoperative myalgias following succinylcholine.
To determine the attenuation in the incidence of myalgia, fasciculations and changes in serum potassium and creatinine kinase concentrations when atracurium and lidocaine were used in combination and separately as pretreatment before succinylcholine.
In a prospective, double blind randomized study, 80 ASA 1 patients 20-50 yr were assigned to one of four groups. Anaesthesia was induced with thiopentone and fentanyl. Group C received placebo pretreatment before 1.5 mg.kg-1 succinylcholine; Group A 0.05 mg.kg-1 atracurium three minutes before; Group L, 1.5 mg.kg-1 lidocaine 30 sec before; and group AL both atracurium and lidocaine. Serum potassium five minutes after succinylcholine, and creatinine kinase 24 hr after operation were measured and the increases from preinduction values were compared. Fasciculations and postoperative myalgia at 24 and 48 hr were recorded. Patients received iv meperidine or po paracetamol for postoperative analgesia.
The increase in serum potassium concentration (0.36 +/- 0.23 mEq.l-1) was not attenuated by any regimen (P < 0.05). The incidence of fasciculations (P < 0.05) and the increase in creatinine kinase (P < 0.01) was less in the atracurium (40%; 20.93 IU.l-1) and atracurium-lidocaine (30%; 22.85 IU.l-1) than in the lidocaine (85%; 45.01 IU.l-1) and control (100%; 56.5 IU.l-1) groups. Postoperative myalgia on Days 1 and 2 was lowest (P < 0.05) in the atracurium-lidocaine group (5%; 0%) followed by the atracurium (35%; 25%) and lidocaine (30%; 35%) groups and highest in the control (75%; 65%).
Atracurium and lidocaine individually reduce postoperative myalgia, with further decrease occurring when used together.
The incidence of postoperative myalgia (POM) after succinylcholine administration has been reported to range from 5% to 83%. The administration of small doses of nondepolarizing muscle relaxants or lidocaine before the administration of succinylcholine has been shown to decrease the incidence and severity of POM experienced by patients. The purpose of this investigation was to compare the severity of POM in subjects receiving pretreatment with rocuronium or lidocaine. Seventy-four subjects were enrolled in this randomized, double-blind investigation to measure the effect of pretreatment modalities on the incidence and severity of myalgia following succinylcholine administration. Pretreatment consisted of either lidocaine, 1.5 mg/kg, or rocuronium, 0.03 mg/kg. Myalgia was measured using a 4-point ordinal scale. Ordinal and nominal data were analyzed using a chi 2 test and the Fisher exact test. A P value of less than .05 was considered significant. Data for 53 subjects were included in the analysis. Of the lidocaine group, 21 (72%) of 29 reported no myalgia at 48 hours compared with only 9 (38%) of 24 in the rocuronium group (P = 0.023). Satisfaction was similar between the groups. Based on the results of this study, pretreatment with lidocaine may provide better relief from myalgia than rocuronium at 48 hours after surgery.
We studied the effects of 3 mg.kg(-1) lidocaine iv on the succinylcholine (SCh)-induced myalgia in 94 unpremedicated ambulant patients undergoing dilatation and curettage of the uterus. The post-SCh myalgia was confirmed through interview by telephone. The data were correlated with the degree of fasciculation and changes in the serum electrolytes and creatine kinase (CK) levels following SCh administration. Pretreatment with lidocaine, 3 mg.kg(-1) iv, significantly reduced the incidence of myalgia from 40.4% of control group to 12.8% lidocaine-treated group, but not the CK levels. The severity of myalgia was not related to the intensity of fasciculation assessed by visual observation. The pretreatment with lidocaine had no untoward effect on the circulation, although the peak arterial and peak venous lidocaine levels achieved were 29.6 +/- 23 micro g.ml(-1) and 10.1 +/- 3.3 micro g.ml(-1) respectively. These finding indicated that the pretreatment with lidocaine, 3 mg.kg(-1) iv, was effective in prevention of SCh-induced myalgia.
229 cases undergoing dental operation were given suxamethonium chloride (“ scoline ”) for endotracheal intubation, and the incidence of post-operative pain attributable to the drug was investigated. Slow administration of suxamethonium does not reduce the incidence and severity of post-operative muscle pain. The only practical and convenient measure to reduce this muscle pain is the administration of 5 mg. of D-tubocurarine or 40 mg. of gallamine triethiodide before the suxamethonium. © 1957, British Medical Journal Publishing Group. All rights reserved.
IN a previous paper (Stevenson, 1960) the changes in the blood electrolytes which may occur as a result of anaesthesia in dogs have been discussed. This paper describes how such changes may be modified by the use of suxamethonium chloride as a muscle relaxant during anaesthesia. Perry and Zaimis (1954) showed that suxamethonium causes the release of potassium from perfused voluntary muscle, while Klupp, Kraupp, Honetz, Kobinger and Loudin (1954) demonstrated that in dogs depolarizing muscle relaxants, including suxamethonium, will cause an increase in the plasma potassium concentration which they claimed to be biphasic. These workers claimed that the potassium concentration could be restored to the normal value by the administration of d - tubocurarine subsequent to the injection of suxamethonium . Paton (1956) has shown in cats that the injection of suxamethonium will cause an increase in the plasma potassium concentration due to release from skeletal muscle which is associated with a partial depolarization of the muscle surface. METHODS
Postoperative muscle pains occurred in 16% of 25 patients given 10 mg diazepam IV 5 minutes prior to succinylcholine. Postoperative muscle pains occurred in 60% of 25 patients not given diazepam before succinylcholine. The difference is statistically significant. Diazepam reduced the severity and duration of postoperative muscle pains, as well as their frequency.
Significant changes in the plasma electrolytes were found in a group of ninety-two female patients in the first 5 min following suxamethonium administration. The plasma potassium rose to a higher level in those patients who developed suxamethonium pains than in those who did not; the plasma calcium decreased in the former group, but increased in the latter. The plasma sodium decreased early in most patients, with the greatest reduction in those patients who did not develop symptoms. A decrease in the level of plasma calcium at 1 min correlated well with the incidence of 'the pains'. There were significant differences in the electrolyte changes, depending on whether thiopentone or Althesin was used for induction, but there was no difference in the incidence of suxamethonium pains. Suxamethonium pains are attributed to damaged muscle-spindles with enhanced calcium release playing an important part.
Clinical doses of succinylcholine caused increases in serum K+, usually less than 0.5 mEq/l. The results confirm that the effect is reduced by administration of thiopental, or pretreatment with d-tubocurarine or pancuronium. Effects of succinylcholine on serum Na+ were minor, with no obvious pattern. All groups, I-VI, demonstrated clearly significant decreases in serum Ca++ following administration of 100 mg succinylcholine, iv. The range of group mean differences was 0.19-0.65. Neither pretreatment with a nondepolarizing muscle relaxant nor type of anesthetic induction had any effect on this response. Based on this evidence, it is reasonable to assume a cause-effect relationship between the iv administation of clinical doses of succinylcholine and the observed decreases in serum Ca++.
SUMMARY Changes in plasma potassium concentration after administration of depolarizing neuromuscular blockers were measured in patients
during halothane-nitrous oxide anaesthesia. Suxamethonium 100 mg intravenously caused a peak rise of 0.55 m.equiv/l. and decamethonium
4 mg produced an elevation of similar magnitude. Injured patients had increases in potassium averaging 1.80 m.equiv/l. there
being a direct correlation between degree of rise and time since injury. By giving tubocurarine 0.1 mg/kg body weight 5 minutes
beforehand, the elevation in potassium caused by suxamethonium, though not by decamethonium, could be halved.
SUMMARY A 3-year-old child with severe tetanus, at the end of the third week of illness, developed circulatory arrest after suxamethonium
injection. A similar incident also occurred in an adult patient with tetanus. Both incidents were attributable to acute hyperkalacmia
induced by suxamethonium. In another patient with severe tetanus, after injection of suxamethonium 100 mg, the potassium level
rose within 2 minutes from 3.8 m.equiv/l. to 7.4 m.equiv/l. Cardiac arrest followed suxamethonium injection also in two patients
with uraemia. One further patient developed ventricular fibrillation when given suxa-methonium three weeks after a road accident
in which he sustained multiple injuries. It is suggested that in these last three instances the increase of serum potassium
caused by the injected suxamethonium was responsible for the circulatory arrest.
SUMMARY The total incidence of muscle pains following suxamethonium in dental out-patients was reduced from 47.6 per cent to 23.2
per cent by the injection of 5 mg gallamine 2 minutes prior to the administration of suxamethonium. The severity of the pains
was also very markedly reduced. Whilst a significant reduction was found in females, a similar reduction was not found in
males which may be due to a relatively smaller dose being given in this group of patients.
Full textFull text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (442K), or click on a page image below to browse page by page.
74
75
Suxamethonium chloride administration and post-operative muscle pain The prevention of muscle pain following succinylcholine by d-tubocurarine
- Cb Collim
- Morris Ddb Dunn
- Ch
CoLLim CB. Suxamethonium pains and fasciculations. Proceedings o f t h e Royal Society qfbfcdicine
11. MORRIS DDB. DUNN CH. Suxamethonium
chloride administration and post-operative muscle
pain. BritiJh Medical Journal 1957; 1: 3 8 3 4.
12. MAYERHOPER 0. The prevention of muscle pain
following succinylcholine by d-tubocurarine.
Survey of Anesthesiology 1961; 5 115-6.
Intravenous lidocaine in the prevention of postoperative muscle pains caused by succinylcholine admitlistration Anesrhesiu and Analgesia; C'urrenr
MOLINA F. Intravenous lidocaine in the prevention
of postoperative muscle pains caused by succinylcholine admitlistration. Anesrhesiu and Analgesia;
C'urrenr Researches 1967; 4 6 225-30.
The effects of muscle relaxants other than muscular relaxation Changes in plasma potassium concentration after depolarizing blockers in anaesthetised man
- Paton Wdm
- Hd
- Heisterkamp
- Cooperman Dv
- Lh
PATON WDM. The effects of muscle relaxants other
than muscular relaxation. Anesthesiology 1959; 2 0
453 63.
3. WEINTRAIJR HD. HEISTERKAMP DV, COOPERMAN
LH. Changes in plasma potassium concentration
after depolarizing blockers in anaesthetised man.
British Journal of Anaesthesia 1969; 41: 1048-52.
Electrolyte changes in the blood after single dose of suxamethonium Changes in total serum C a + + , N a + and K + with administration of succinylcholine
- Jassal Os
- Ahluwalia Bs
- Singh Bourke Dl
JASSAL OS, AHLUWALIA BS, SINGH P. Electrolyte
changes in the blood after single dose of suxamethonium. Indian Journal of Anaesthesia 1976;
6. BOURKE DL, ROSENBERG M. Changes in total
serum C a + +, N a + and K + with administration
of succinylcholine. Anesthesioloxy 1978; 4 9 361-
3.
Diazepam and succinylcholine induced muscle pains. A m < -thesia and Analge.cia: Current Researchr
- Chatterji S Verma Rs
- Mathur N
VERMA RS, CHATTERJI S. MATHUR N. Diazepam
and succinylcholine induced muscle pains. A m < -thesia and Analge.cia: Current Researchr.7 1978;
57: 295 7.
- Chiikchill-Davidson Hc
CHIIKCHILL-DAVIDSON HC.
Suxamethonium
1975; 68: 105-8.
Electrolyte changes in the blood after single dose of suxamethonium
- Jassal Os
- Ahluwalia Bs
- Singh P
JASSAL OS, AHLUWALIA BS, SINGH P. Electrolyte
changes in the blood after single dose of suxamethonium. Indian Journal of Anaesthesia 1976;
Intravenous lignocaine for prevention or muscle pain after succinylcholine
- Haldia Kn
- Kackar Chatterji S
- Sn
HALDIA KN. CHATTERJI S, KACKAR SN. Intravenous lignocaine for prevention or muscle pain
after succinylcholine. Anesthesia and Analgesia.
Current Reseurchrs 1973: 5 2 849-52.
Changes in plasma potassium concentration after depolarizing blockers in anaesthetised man
- Weintraijr Hd
- Cooperman Heisterkamp Dv
- Lh
WEINTRAIJR HD. HEISTERKAMP DV, COOPERMAN
LH. Changes in plasma potassium concentration
after depolarizing blockers in anaesthetised man.
British Journal of Anaesthesia 1969; 41: 1048-52.
Changes in blood electrolytes of anaesthetised dogs caused by suxamethonium
- Stevenwn De
STEVENWN DE. Changes in blood electrolytes of
anaesthetised dogs caused by suxamethonium.
British Journal of Anaesthesia 1960; 32: 36471.
Suxamethonium pains: hypothesis and observations
- Mapleson Waters Dj
- Ww
WATERS DJ, MAPLESON WW. Suxamethonium
pains: hypothesis and observations. Anaesthr.7ia
1971; 2 6 12741.
Suxamethonium pains and fasciculations
- C B Collim
CoLLim CB. Suxamethonium pains and fasciculations. Proceedings o f t h e Royal Society qfbfcdicine
The incidence and aeverity of muscle pain after suxamethonium when preceded by gallamine
- Glacjber D
GLACJBER D. The incidence and aeverity of muscle
pain after suxamethonium when preceded by
gallamine. British Journal of Anaesthrsia 1966: 38:
541-4.
- C'urrenr
C'urrenr Researches 1967; 4 6 225-30.
Post-suxamethonium pains and vitamin C. Anaesthesia I97 I
- Savant Gupte Sr
- Ns
GUPTE SR, SAVANT NS. Post-suxamethonium
pains and vitamin C. Anaesthesia I97 I ; 2 6 43640.
Changes in plasma potassium concentration after depolarizing blockers in anaesthetised man
- Weintraub
Uber die Freisetzung Von Kalium aus der Muskulatur Unter der Einwirkung einiger Muskelrelaxantien
- Klupp H
Electrolyte changes in the blood after single dose of suxamethonium
- Jassal OS