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Background: This study aimed to evaluate the effect of two prophylactic different doses of magnesium sulfate on succinylcholine complications in elective cesarean section under general anesthesia in comparison with control group. Methods: In a clinical trial study, 165 pregnant women candidates for cesarean section were divided into three groups of 55, receiving 30 or 40 mg/kg magnesium sulfate, or normal saline (placebo) under general anesthesia. Hemodynamic parameters were measured and recorded during recovery and operation, as well as the serum levels of magnesium, potassium, and creatine phosphokinase (CPK) before receiving magnesium sulfate, and 20 minutes after induction of anesthesia. Moreover, myoglobinuria was measured and recorded. Findings: Specific reductions were found in moderate blood pressure and heart rate at third minute after laryngoscopy in groups receiving magnesium sulfate (P < 0.001 for both). Fasciculation was observed in 53.6% of the patients receiving magnesium sulfate, and 87.2% of the patients in the placebo group. The fasciculation observed in groups receiving magnesium sulfate was classified as mild. Conclusion: Administration of magnesium sulfate 30 mg/kg as well as 40 mg/kg before cesarean section under general anesthesia can effectively reduce the severity of fasciculation and myalgia, and the effects of succinylcholine on rapid induction of anesthesia in pregnant women.

Introduction: Rapid Sequence Induction and Intubation (RSII) is used when the patient is at high risk of pulmonary aspiration of gastric contents. Various side effects of succinylcholine such as sore throat, fasciculation, and myalgia led us to search for a solution to mitigate succinylcholine’s complications. The goal of this study was, therefore, to determine if the Intravenous (IV) administration of lidocaine can affect the incidence of succinylcholine-based sore throat, myalgia, and fasciculation following an appendectomy. Materials and Methods: A clinical trial was performed in 2016 on 90 patients (aged 15-70) who were referred to Shahid Mohammadi Hospital (Bandar Abbas, Iran) for an appendectomy. Patients were randomly divided into two groups. Patients’ demographic information (e.g. age, weight, and gender) were recorded. Participants in the first and second groups received lidocaine and normal saline (NSS), respectively, immediately following RSII and shortly before succinylcholine administration. Patients were asked to survey them in terms of any sore throat, myalgia, and fasciculation symptoms. Data were analyzed using IBM SPSS Statistics 23.0, and descriptive and inferential statistics. Results: Fifty-five percent of the participants were male and forty-five percent were female. The mean age at the group receiving normal saline was three years more than that of the group receiving lidocaine. The incidence of sore throat was considerably lower in patients receiving lidocaine. The incidence of myalgia was nearly equal in both groups. And the rate of mild fasciculation incidence was higher in the group receiving lidocaine, while patients receiving normal saline experienced a higher rate of severe fasciculation incidence. Conclusion: The use of lidocaine has no significant effect on the incidence of succinylcholine side effects such as the intensity of sore throat, myalgia, and fasciculation. [ABSTRACT FROM AUTHOR]

Background: Succinylcholine is the most common muscle relaxant but its side effects resulted in researches for a drug as alternative. The aim of present study was to compare the effects of succinylcholine and remifentanil on intubating conditions in elective cesarean section. Methods: Patients undergoing elective cesarean (n = 200) were enrolled in a double-blinded clinical trial study in Ali Ibne Abitaleb hospital, Zahedan, Iran. Patients were divided in 2 groups of control, received succinylcholine (1.5 mg/kg), and case, received remifentanil (1 µg/kg). Statistical analysis was performed using Fischer’s exact and chi-square tests via SPSS software at the significant level of P < 0.050. Findings: In the succinylcholine group, 92 patients (92%) and in the rhymifentanil group, 76 patients (76%) had good intubation (P < 0.050). Apgar score of 1st minute was less than 7 in 2 (2%) and 14 (14%) newborns in succinylcholine and rhymifentanil groups, respectively (P < 0.050). In case group, Apgar score of 5th minute was seen in 6 newborns (6%), while there was not any case in control group. Conclusion: Our results suggest that with respect to the effect of remifentanil on Apgar, it could be used only in contraindications of succinylcholine in suitable conditions of monitoring and effective resuscitation of neonates.

مقدمه: در بیمارانی که تحت درمان الکتریکی- تشنجی هستند، از سوکسنیل کولین استفاده می‌گردد و از سیس‌ آتراکوریوم به صورت محدود در حد گزارش موردی در جهان استفاده می‌شود. هدف از انجام این مطالعه، بررسی تغییرات همودینامیک در تجویز سوکسینیل کولین و سیس آتراکوریوم در درمان الکتریکی- تشنجی بود. روش‌ها: مطالعه بر روی 68 بیمار کاندیدای دریافت درمان الکتریکی- تشنجی انجام گردید. با استفاده از روش نمونه‌گیری آسان، بیماران به دو گروه 34 نفری تقسیم شدند و دو دارو به صورت تصادفی ساده به هر بیمار اختصاص داده شد. برای مقایسه‌ی متغیرها، از آزمون‌های Independent t و 2χ استفاده گردید. یافته‌ها: بین میانگین مدت زمان تشنج، زمان برگشت تنفس خودبه‌خودی از زمان قطع تشنج، مدت زمان پایان تشنج تا هوشیاری کامل و زمان اقامت در ریکاوری، در دو گروه اختلاف معنی‌داری وجود داشت (050/0 > P)؛ به طوری که متوسط مدت زمان تشنج در سیس آتراکوریوم (16/8 ± 02/38 ثانیه) بیشتر از سوکسینیل کولین (23/5 ± 87/29 ثانیه) بود، اما زمان برگشت تنفس خودبه‌خودی، زمان تشنج تا هوشیاری کامل و زمان اقامت در ریکاوری، در سوکسینیل کولین بیشتر از سیس آتراکوریوم بود. نتیجه‌گیری: سیس آتراکوریم، از نظر مدت اثر، متوسط ‌می‌باشد. استفاده از دز کم آن در مقایسه با سوکسنیل کولین، متوسط مدت زمان برگشت تنفس خودبه‌خودی کوتاه‌تری دارد. همچنین، بروز عوارض در سیس آتراکوریوم نسبت به سوکسینیل کولین، بسیار کمتر است و در درمان الکتریکی- تشنجی، جایگزین مناسب‌تری نسبت به سوکسینیل کولین می‌باشد.

BACKGROUND AND OBJECTIVE: One of the most important purposes in emergency anesthesia in patients undergoing ophthalmic surgery is prevention of gastric content aspiration and increase in intraocular pressure (IOP) during endotracheal intubation. Priority in prevention of gastric content aspiration necessitates use of rapid intubation technique by succinylcholine. The aim of this study was to evaluate the effect of nifedipine on intraocular pressure following endothracheal intubation after administration of succinylcholine.METHODS: In a clinical trial study, 64 patients aged 15-60 years old (ASA class I) were candidated for non ophthalmic surgery. They were randomly divided into two equal groups. Anesthetic technique was similar in both groups. In case group, 10mg sublingual nifedipine was administered 20 minutes before induction and in control group 10 drops of placebo were administered. IOP was measured by schiotz tonometer just before nifedipine and placebo administration and at 1, 3 and 5 minutes after induction.FINDINGS: In this study, mean IOP before induction was 12.5±2.8 and 13.9±3.2 mmHg in nifedipine and control group, respectively that this difference was not statistically significant. Mean IOP at 1, 3 and 5 minutes was 13.3±2.9, 14.3±3.2 and 11.6±2.9 mmHg in nifedipine group and also 17.9±3.5, 21.5±3.5 and 16.9±3.2 mmHg in control group, respectively (p

Introduction: Orotracheal intubation is a common method for airway management in critical situations and for performing different surgeries in operating rooms under general anesthesia. Firstly, an ultra short- acting anesthetic is administered by intravenous (i.v), mask ventilation instituted and then the most common depolarizing muscle relaxant, succinylcholine, injected. Since succinylcholine and other muscle relaxants have some adverse effects, the current study was performed to present an alternative method for endotracheal intubation without muscle relaxants in some certain situations. Materials and Methods: The present study was a double-blinded clinical trial, which it is performed on 150 elderly patients in Nikocari Hospital, Tabriz. The patients were divided into two groups, study and control. The patients were elective and anesthesia technique was general anesthesia with endotracheal intubation. Patient selection was based on the physical status classification by American Society of Anesthesiologists (ASA). Therefore, the patients who categorized as class I and II of the ASA classification were selected. All the patients’ airway classification was class I with respect to Mallampati test. lidocaine 1-1.5mg/kg, midazolam 1mg, alfentanyl 30 μg/kg, and propofol 2mg/kg was administered for patients in the study group. Patients in the control group were received the following drugs: lidocaine 1-1.5mg/kg, midazolam 1mg, propofol 2mg/kg and succinylcholine 1-1.5 mg/kg. In the study, all the patients were intubated by an anesthesiologist who was not aware of the medications administered and airway classification. Data collection including the time of consciousness loss, jaw relaxation, quality of ventilation, vocal cards position, patients’ response to laryngoscopy, duration of laryngoscopy, was performed using a questionnaire. Statistical analysis was performed by SPSS software. Results: 51.7% of patients were male and 48.3% were female. Average age of the patients was 61.19 ±12.06 year and their weight mean was 591.06Kg. Only 45% of the patients had a previous history of anesthesia and surgery, but none of them had an experience of difficult intubation. According to ASA classfication, 26.7% of the patients were in class І and 73.3% in class II. All patients had the capability of head extension and mouth opening more than 40mm. In the study group, loss of consciousness occurred in less than one minute and more than two minutes was respectively observed in 35% and 1.7% of the patients. No significant difference was detected between the study and the control group with respect to loss of consciousness. Jaw relaxation was very good in 86.7% of patients and ventilation was easy in 94.5% of patients in the study group. In the control group, jaw relaxation was excellent in 98.2% of patients and ventilation was easy about all patients. Vocal cords had an open and complete view in 91.2% of cases in the study group, while it was 94% in control group (p

Introduction: Succinylcholine is a depolarizing muscle relaxant, which has been used extensively in anesthesia to produce muscle relaxation. The present study was done with the aim of comparing Fasciculation and postoperative myalgia after injection of two different doses of Succinylcholine (1.5 mg/kg and 3 mg/kg). Materials and Methods: In this study which has been conducted in the form of Randomized double blind study in Tehran Shariati Hospital in the year 2000, 50 male patients in two groups (25 in each) with ASA I&II, age between 18 to 65, were candidate for an elective surgical repair of inguinal hernia received a standard anesthetic technique, including one of the two doses of Succinylcholine. Results: After collecting data it has been considered that the average difference of two respective groups is meaningful in terms of fasciculation (P0.05). Conclusion: we came to the conclusion that, firstly, the percentage of myalgia after the injection of succinylcholine is totally low and with the increase of the dose of medication from 1.5 mg/kg to 3 mg/kg the very percentage does not change considerably. Secondly, regarding fasciculation the increase of the dose of medication from 1.5 mg/kg to 3 mg/kg causes the decrease of the average limit of fasciculation. This decrease is very obvious in server fasciculation. As a matter of fact no relationship was found between decrease in fasciculation and change in myalgia.