[Comparison of incidence of succinylcholine-induced fasciculation and postoperative Myalgias]

Fasciculation and myalgia are common complications of succinylcholine and decrease of incidence and intensity of them will reduce succinylcholine-induced side effects. This study was done to evaluate the severity and prevalence of fasciculation and myalgia after succinylcholine and perform a comparison between three groups. In this case - control study in 2006, 75 patients with ASA I and orthopedic surgery were evaluated in Imam Reza hospital. The patients divided randomly in to three same groups. In first group thiopental and succinylcholine 1.5 mg/kg was injected, in second group propofol 2 mg/kg and succinlycholine 1.5 mg/kg and in third group thiopental and succinylcholine 3 mg/ kg was administered. Fasciculation, intubation quality after 1 min, and myalgia after 24 h were analyzed. Demografic parameters, pain scales and fasciculation data were gathered in a questionnaire and analyzed by SPSS, descriptive statistics and frequency distribution tables. Fasciculation rate was%76 in first group, 80% in second group, and%84 in third groups. Myalgia was%24 in first group,%28 in second group, and%20 in third group. There were no significant differences between group 1 and 2 and also 1 and 3 with respect to fasciculation, Intubation, and post-operative myalgia. We concluded that propofol aggregates muscular relaxation versus thiopental, and low-dose versus high-dose of succinylcholine and chang to phase II block had no differences regarding to these complications

[Bilateral pneumothorax due to jet ventilation, a case report]

Jet ventilation is one of the procedures that do not need intubation. Jet ventilation is used in difficult intubation, diagnostic laryngoscopy and micro laryngeal surgery, adult respiratory distress syndrome and bronchopleural fistulas. Jet ventilation has done by a thin cannula such as angiocath from oral or nasal route or cricothyroid membrane. Respiratory rate is 10-15/min in low frequency or 100-200/min in high frequency and tidal volume is 1-2 cc/kg to 5-10 cc/kg and O[2] pressure is 15-50 psi with high flow. Major complication is this procedure is cannula kink, hyperinflation, pneumothorax and sub cutaneous emphysema. In this patients for good exposure of the layrnx and immobility of the vocal cords, a nelaton cath was used from oral route into trachea and jet ventilation was done with 10-15/ min and 5cc/kg. Total IV anesthesia was done. Air-trapping and bilateral pneumothorax was caused due to pharyngeal obstruction and hemorrhage. Then the problem was resolved rapidly with bilateral chest tubes. The patient discharges after 3 days. Therefore when this procedure was used, we must be careful for expiration. Airway obstruction is treated rapidly and jet ventilation is stopped soon