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How best to prevent the muscle fasciculations and diffuse myalgia associated with succinylcholine? These investigators performed a formal meta-analysis of randomized, controlled trials of pretreatment agents; the analysis was limited to agents that were evaluated in at least three trials. Of 161 studies identified, 52 met all criteria for inclusion. Forty-three trials evaluated both fasciculation and myalgia, 6 evaluated myalgia alone, and 3 evaluated fasciculation alone; the studies included 5318 patients.
The baseline incidences of myalgia and of fasciculation in the control groups were 51% and 94%, respectively. Myalgia at 24 hours was significantly less common with thiopental induction (49.2%) than with propofol (65.4%) induction. Use of…