To Study the Effect of Pre-treatment with Lidocaine & Diclofenac In Reducing Succinylcholine Induced Myalgia

Abstract

Objective: 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. Post-operative myalgia is a minor but frequent adverse effect of succinylcholine administration. The purpose of this study is to compare the effect of pre-treatment with IV lidocaine versus IM diclofenac in succinylcholine induced post-operative myalgia Methods: 120 consenting adult in patients of Pad. Dr. Vithalrao Vikhe Patil Foundation’s Medical College & Hospital, Ahmednagar, who were posted for elective minor surgery, under general anaesthesia, between the age group of 18-50 years with ASA physical status I & II were selected for the study. They were further divided into three groups of 40 each: Group D to receive 75mg IM diclofenac pre-treatment, Group L IV lidocaine 1.5 mg/kg and Group C-the controls. Patients were pre-oxygenated and induced with 5mg/kg IV thiopentone sodium followed by 1.5mg/kg IV of succinylcholine. The presence and degree of fasciculation were assessed visually on a four point scale. The severity and intensity of post-operative myalgia were assessed by the investigator with a standardized questionnaire 1 jhour, 24 hours and 48 hours after surgery. Result: IV lidocaine showed a statistically significant (p<0.16) 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. Conclusion: Intravenous lidocaine is effective in the prevention of post-operative succinylcholine induced myalgia.