مقايسه آثار فني تويين و پانكورونيوم در پيشگيري از دردهاي عضلاني ناشي از تجويز سوكسينيل كولين

Comparison of the Effects of Phenytoin and Pancuronium in Prevention of Succinyl-induced Muscle Pain

Background and Objectives: The incidence of muscle pain following administration of succinylcholine. varies from 2-89% and this type of pain occurs more frequently following minor surgery, especially in women and in ambulatory rather than bedridden patients. To prevent this, we studied the pretreatment with phenytoin and pancuronium for their preventive effects. Materials and Methods: In a prospective randomized trial carried out in medical center of Imarn Khomeini Hospital, 64 adult patients who underwent elective routine surgery with anesthesia of class ASA I (American society of anesthesiologists), were observed 24, 48 and 72 hours after surgery to evaluate muscular pain. Tc determine the efficacy of intravenously administered phenytoin (5 mg/kg) in prevention of induced myalgia. patients were allocated randomly in three groups: Group I received phenytoin 5 mg/kg 5 minutes before induction of anesthesia, group II received pancuronium 0.5 mg 3 minutes before induction of anesthesia, and group III did not recieve any pretreatment before succinylcholine. Results: Incidence of myalgia in group I was 20%; it was 43.3% in group II and 71.4% in group III. Incidence of fasciculations in groups I, II, and III was 55% , 38% and 100% , respectively. Conclusion: Phenytoin and pancuronium both significantly reduces incidence and severity of pain and fasciculations induced by suxamethonium. The incidence and severity of pain and fasciculations after phenytoin adminstration, are significantly less than those in pancuronium and control groups. Preinduction administration of phenytoin, effectively reduces myalgia and fasiculations and in this regard, acts better than pancuronium.