THE INCIDENCE AND SEVERITY OF MUSCLE PAINS AFTER SUXAMETHONIUM WHEN PRECEDED BY GALLAMINE BY

The total incidence of muscle pains following suxamethonium in dental out-patients was reduced from 47.6 per cent to 23.2 per cent by the injection of 5 mg gallamine 2 minutes prior to the administration of suxamethonium. The severity of the pains was also very markedly reduced. Whilst a significant reduction was found in females, a similar reduction was not found in males which may be due to a relatively smaller dose being given in this group of patients. The incidence of muscle pains and stiffness after the administration of suxamethonium, and attempts at prevention or reduction, have been the subjects of numerous papers. Churchill-Davidson (1954) first reported the modifying effects of the administration of non-depolarizing relaxants before suxamethonium, using compara-tively large doses (gallamine 40 mg or tubo-curarine 5 mg). Morris and Dunn (1957), Lamoreaux and Urbach (I960), Foster (I960), Burtles and Tunstall (1961) and White (1962) have all reported the results of series in which this principle has been investigated. White (1962) demonstrated the effectiveness of a small (5 mg) dose of gallamine when an interval of 2 minutes was allowed to elapse between the gallamine and suxamethonium injections; with this measure the incidence of muscle pains in patients undergoing bronchoscopy was reduced from 50 per cent to 28 per cent, with a corresponding reduction in the severity of the pains. The purpose of the present investigation was to assess White's technique in a series of dental out-patients. METHOD The present series was composed of physically fit patients attending for dental operations (extrac-tions and conservations) and who were anaes-thetized by one or other of five specialist anaesthetists. The anaesthetic technique wa