Effects of pretreatment with cisatracurium, rocuronium, and d-tubocurarine on succinylcholine-induced fasciculations and myalgia: A comparison with placebo

Girish P. Joshi, Amaha Hailey, Steven Cross, Gwendell Thompson-Bell, Charles C. Whitten

Research output: Contribution to journalArticle

20 Scopus citations


Study Objective: To evaluate the efficacy of cisatracurium, rocuronium, and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ambulatory surgery. Design: Randomized, prospective, placebo-controlled trialSetting: Teaching hospital. Subjects: 80 ASA physical status I and II patients scheduled for elective ambulatory surgery with general anesthesia.Intervention: A standardized balanced anesthetic technique was used for all patients. Measurements and Main Results: Patients were randomized to receive cisatracurium 0.01 mg/kg, rocuronium 0.06 mg/kg, d-tubocurarine 0.05 mg/kg, or saline, 3 minutes prior to intravenous (IV) succinylcholine 1.5 mg/kg. The intensity of fasciculations and intubating conditions were assessed using a four-point rating scale. In addition, the severity of myalgia was assessed using a four-point rating scale in the postanesthesia care unit and at 24 hours postoperatively. No patient complained of any side effects after the administration of the study drug. Fasciculations were observed less frequently (p < 0.05) in the d-tubocurarine and rocuronium groups compared with the placebo and cisatracurium groups. However, there was no difference between the d-tubocurarine group and the rocuronium group (21% vs. 10%, respectively). Although fasciculations occurred less frequently in the cisatracurium group than in the placebo group (59% vs. 85%, respectively), this difference did not reach statistical significance. There was no difference among the four groups in the intubating conditions or the incidence of postoperative myalgia.Conclusion: Pretreatment with rocuronium and d-tubocurarine was superior to cisatracurium in preventing succinylcholine-induced fasciculations. However, pretreatment did not have any effect on the incidence of myalgia after ambulatory surgery. Copyright (C) 1999 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)641-645
Number of pages5
JournalJournal of Clinical Anesthesia
Issue number8
Publication statusPublished - Dec 1999



  • Cisatracurium
  • D-tubocurarine
  • Fasciculations
  • Myalgia
  • Neuromuscular nondepolarizing blocking drugs
  • Rocuronium
  • Side effects
  • Succinylcholine

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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