A STUDY OF THE EFFECT OF PRETREATMENT WITH LIDOCAINE AND DICLOFENAC IN REDUCING SUCCINYLCHOLINE INDUCED MYALGIA

Rithesh D’Cunha; Shannon Fernandes; Elroy Saldanha

Volume : VII, Issue : IV, April - 2017

A STUDY OF THE EFFECT OF PRETREATMENT WITH LIDOCAINE AND DICLOFENAC IN REDUCING SUCCINYLCHOLINE INDUCED MYALGIA

Rithesh D Cunha, Shannon Fernandes, Elroy Saldanha

Abstract :

Succinylcholine, a depolarizing muscle relaxant, known for its rapid onset of action and fast emergence, is the preferred muscle relaxant for ambulatory anaesthesia, short surgical procedures and rapid sequence induction as it provides almost ideal intubating conditions.

Postoperative myalgia is a minor but frequent adverse effect.

Several drugs have been observed to decrease the incidence and severity of post operative myalgia; lidocaine and diclofenac being the safer of these. However, no study compares their efficacy. The purpose of this study was to compare the effect of pretreatment with intravenous lidocaine versus intramuscular diclofenac in succinylcholine induced post operative myalgia.

120 consenting adult in–patients of Father Muller Medical College Hospital who were posted for elective minor surgery, under general anaesthesia, between the age group of 18–50 years with ASA physical status I and II were selected for the study. They were further divided into three groups of 40 each :Group D– 75 mg intramuscular diclofenac pretreatment, Group L – intravenous lidocaine 1.5 mg/kg and Group C – controls.

Patients were pre–oxygenated and induced with 5mg/kg IV thiopentone sodium followed by 1.5 mg/kg of succinylcholine. The severity and intensity of post operative myalgia were assessed with a standardized questionnaire 1 hour, 24 hours and 48 hours after surgery.

RESULTS

IV lidocaine showed a statistically significant (p<.016) reduction in the incidence and intensity of succinylcholine induced myalgia. IM diclofenac showed no such reduction when compared to the control group. When compared to diclofenac, lidocaine proved to be more efficacious in reducing the incidence and intensity of pain at all of the three time points.