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Administration of a non-depolarizing neuromuscular blocking agent (NMBA) can attenuate muscle fasciculations after succinylcholine (SCh) administration. Which of these agents is most effective?
Researchers from Quebec randomized 120 healthy women undergoing laparoscopic surgery to saline placebo or one of five non-depolarizing NMBAs: d-tubocurarine (0.05 mg/kg), vecuronium (0.01 mg/kg), atracurium (0.05 mg/kg), mivacurium (0.02 mg/kg), or rocuronium (0.06 mg/kg). All agents were followed three minutes later by fentanyl (1 μg/kg) and propofol (2.5 mg/kg) and another minute later by SCh (1.5 mg/kg). Ease of intubation (attempted 90 seconds after the SCh) and fasciculations were each graded on a 4-point scale.
Fasciculations occurred in 19 of 20…