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Succinylcholine (SCh) induces fasciculations that have been related to myalgia and elevations in intracranial pressure (ICP). Administration of one tenth of the paralytic dose of a competitive neuromuscular blocking agent (NMBA) three minutes before SCh administration reduces fasciculations and may alleviate ICP and myalgia. To determine whether rocuronium's fast onset of action could achieve defasciculation more rapidly, Canadian researchers randomized 42 ASA class I or II patients to normal saline, atracurium (0.1 mg/kg), or rocuronium (0.1 mg/kg), given intravenously only 30 seconds before administration of SCh (1.5 mg/kg).
All patients were premedicated with fentanyl (1.5 μg/kg) and lidocaine (0.5 mg/kg) and were induced with propofol (2…