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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Preoperative pregabalin prevents succinylcholine-induced fasciculation and myalg...
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Vol. 71. Issue 4.
Pages 324-331 (April 2024)
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Vol. 71. Issue 4.
Pages 324-331 (April 2024)
Review
Preoperative pregabalin prevents succinylcholine-induced fasciculation and myalgia: A meta-analysis of randomized trials
La pregabalina preoperatoria previene la fasciculación y la mialgia inducidas por la succinilcolina: un metanálisis de ensayos aleatorizados
P.A. Véleza, V. Lara-Erazob,, A.F. Caballero-Lozadaa, A. Boteroa, G. Lozadac, A.F. Velásqueza, L.M. Villegasa, A. Zorrilla-Vacaa,d,
Corresponding author
a Department of Anesthesiology, Universidad del Valle, Cali, Colombia
b Anesthesiology Research Department, Mass Eye & Ear Institute, Harvard Medical School, Boston, MA, USA
c Department of Anesthesiology, Mass Eye & Ear Institute, Harvard Medical School, Boston, MA, USA
d Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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Table 1. Characteristics of the included trials.
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Abstract

Succinylcholine is the gold standard neuromuscular blocker for rapid sequence induction; however, its use is associated with fasciculation and myalgia. We performed a systematic review and meta-analysis of randomized controlled clinical trials comparing gabapentinoids versus placebo for the prevention of fasciculations and succinylcholine-induced myalgias. Six randomized clinical studies were included with a total of 481 patients - 241 in the intervention group and 240 in the placebo group. Gabapentinoids reduced the incidence of succinylcholine-induced myalgia (RR=0.69, 95% CI 0.56−0.84, P<.001), which remained statistically significant for pregabalin (RR=0.71, 95% CI 0.54−0.93, P=.013) and gabapentin (RR=0.61, 95% CI 0.45−0.82, P=.001) separately. There was no difference in fasciculations between the groups (RR=0.92, 95% CI 0.82–1.03, P=.148). Preoperative use of gabapentinoids is associated with lower incidence of succinylcholine-induced myalgias within the first 24h of surgery.

Keywords:
Gabapentinoids
Fasciculation
Myalgia
Pregabalin
Gabapentin
Succinylcholine
Resumen

La succinilcolina es el bloqueador neuromuscular de referencia para la inducción de secuencia rápida, sin embargo, su uso se asocia a fasciculaciones y mialgias. Se realizó una revisión sistemática y un metanálisis. Se incluyeron ensayos clínicos controlados aleatorios comparando gabapentinoides versus placebo, para la prevención de fasciculaciones y mialgias inducidas por succinilcolina. Se incluyeron seis estudios clínicos aleatorizados. El número total de pacientes fue de 481, de los cuales 241 estaban en el grupo de intervención y 240 en el grupo de placebo. Los gabapentinoides redujeron la incidencia de mialgia inducida por succinilcolina (RR=0,69, IC del 95% 0,56–0,84, P<,001), que siguió siendo estadísticamente significativa para la pregabalina (RR=0,71, IC del 95% 0,54-0,93, P=,013) y la gabapentina (RR=0,61, IC del 95%: 0,45 a 0,82, P=,001) por separado. No hubo diferencia entre el grupo en las fasciculaciones (RR=0,92, IC del 95%: 0,82 a 1,03, P=,148). El uso preoperatorio de gabapentinoides se asocia con una menor incidencia de mialgias inducidas por succinilcolina dentro de las primeras 24 horas posteriores al procedimiento.

Palabras clave:
Gabapentinoides
Fasciculaciones
Mialgias
Pregabalina
Gabapentina
Succinilcolina

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