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Jaw muscle tension after succinylcholine in children undergoing strabismus surgery
J M Saddler1, J C Bevan, M H Plumley
1Department of Anesthesia, Montreal Children's Hospital, Quebec.
Insights
Succinylcholine causes similar jaw tension increases and neuromuscular blockade in children undergoing strabismus surgery compared to general surgical patients. This study found no significant differences in muscle response to the anesthetic agent.
Area of Science:
- Anesthesiology
- Pharmacology
- Pediatric Surgery
Background:
- Succinylcholine is a common neuromuscular blocking agent used in anesthesia.
- Understanding its effects in specific pediatric populations, like those with strabismus, is crucial for safe practice.
Purpose of the Study:
- To compare the effects of succinylcholine on masseter and adductor pollicis muscle tension and neuromuscular blockade in children with strabismus versus general surgical patients.
Main Methods:
- Eight children (3-10 years) with strabismus received succinylcholine (1 mg/kg) during halothane anesthesia.
- Train-of-four (TOF) stimulation was applied to the ulnar and masseter nerves simultaneously.
- Jaw closure force and neuromuscular blockade onset were measured and compared to a control group.
Main Results:
- Succinylcholine increased resting muscle tone in both jaw and thumb in all patients.
- The magnitude and duration of this increase were not significantly different between strabismus and control groups.
- Neuromuscular blockade onset was significantly faster at the masseter than the adductor pollicis in both groups.
Conclusions:
- Succinylcholine produces comparable increases in jaw tension and degrees of neuromuscular blockade in pediatric strabismus surgery patients as in other children.
- The findings support the safe use of succinylcholine in pediatric strabismus surgery.
Abstract:
The increases in tension at the masseter and adductor pollicis muscles following succinylcholine, 1 mg.kg-1, during halothane anaesthesia were measured in eight children, 3-10 yr, with strabismus. The results were compared with those obtained in a control group of general surgical patients. Supramaximal train-of-four (TOF) stimulation was applied to the ulnar nerve and the nerve to the masseter simultaneously. Jaw closure was measured by a force transducer system. In all patients, succinylcholine caused an increase in resting tone at the jaw and at the thumb. In the strabismus group, the magnitude of this increase was 55.7 +/- 23.2 g, mean +/- SD, at the jaw and 11.3 +/- 5.6 g at the thumb. This was not significantly different from the values obtained in controls, 45.3 +/- 33.4 g and 7.9 +/- 4.2 g, respectively. The duration of the phenomenon was 1-2 min in both muscles studied, and was not statistically different in the strabismus group. Time to complete neuromuscular blockade was significantly faster at the masseter, 31 +/- 6 sec--control groups; 39 +/- 11 sec--strabismus group, than at adductor pollicis, 61 +/- 34 sec--control groups; 75 +/- 28 sec--strabismus group (P less than 0.05 and 0.013 respectively). It is concluded that succinylcholine causes similar increases in jaw tension and comparable degrees of neuromuscular blockade in patients undergoing strabismus surgery as in other children.