Study on the effect of alfentanil and sufentanil on fasciculation of succinylcholine

Succinylcholine is a depolarizing muscle relaxant that is widely used by anesthesiologists especially at induction time to facilitate intubations. Fasciculation is common after intravenous injection of succinylcholine and preceeding relaxation may cause myalgia, rhabdomyolysis and increase in blood level of myoglobulin. On the other hand, narcotics are the main components of induction protocols and alfentanil as a short acting narcotic is widely used. Decreasing fasciculation can be achieved probably by use of alfentanil. Alfentanil and Sufentanil were used in our study to evaluate this proposal. Patients were selected randomly [female aged 20-50, ASA I]. Induction of anesthesia was done by thiopental Na [4mg/kg] and relaxation for intubation reached by Succinylcholine [1mg/kg]. Premedication was as follows: in the 1[st] group alfentanil [10 micro g/kg, 2 minutes before Succinylcholine injection]; in the 2[nd] group Sufentanil [0.1micro g/kg, 4 minutes before Succinylcholine injection] and in the 3 [rd] group [control group] normal saline [0.5-2 ml, 2 minutes before Succinylcholine injection]. The zero score was 64%, 12% and 8% in groups 1 to 3 respectively while the three scores were 15%, 50% and 57% in groups 1 to 3 respectively. Statistical analysis revealed that alfentanil induced more fasciculation suppression than sufentanil [p<0.0001]

Propranolol therapeutic effect on post spinal anesthesia headache

Headache is a complication of spinal anesthesia, which also cause fear in scheduled patients. Headache may have a severity which may disturb patient's life. Headache also can persist from days to months. Many different measures can be used for preventing that; including small size needles, delay in ambulation, hydration and so on. This study was conducted to evaluate the therapeutic effects of propranolol on post spinal anesthesia headache. This is a double blind clinical trial. In this study we selected 60 patients [from ASA class I, II] who undergone operation [gynecological and urorlogical] with spinal anesthesia and had post spinal headache. Patients were randomly divided into 2 groups for treatment. The first group was treated with propranolol, 20 mg, twice a day and the second group was treated with acetaminophen, 325mg, twice a day. Pain severity was measured by Mankosky pain scale. Collected data were analyzed using SPSS software. Mean of severity of pain was 6.33 versus 4.6 in propranolol group [before and after treatment] and 6.36 versus 5.56 in acetaminophen group [before and after treatment]. These differences were statistically significant [p<0.05]. Propranolol can be used for treatment of post spinal headache in patients who has no contraindication for use of this medicine