Effect of Succinylcholine on Patients Using Statins

The Cleveland Clinic70 enrolled

Overview

Based on available mechanistic and clinical information, the investigators propose a nonrandomized study to evaluate the effect of succinylcholine in patients taking statins. The investigators' purpose is to evaluate the effect of succinylcholine on patients taking statins. Patients scheduled to undergo elective surgery (other then orthopedic, spinal, vascular or muscle) with planned endotracheal intubation will be approached regarding participation in the trial. Design of the study is complex because there is no way to randomize patients to statins or no statins and also no way to take them off the statins prior surgery. So statin use will not be randomized; confounding factors will be accounted for by stratification (every 10 years of age from 40-80 and gender) and statistical adjustment. The investigators propose to test the hypothesis that succinylcholine administration increases plasma myoglobin concentration more in patients who are on statins compared to patients who do not.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Pain

Interventions

Eligibility

Sex: ALLMin age: 40 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Scheduled for elective surgery not involving orthopedic procedure, muscle and spinal surgery * ASA Physical Status 1-3 Exclusion Criteria: * History of liver failure * History of renal failure * History of neuromuscular disease * Increased intraocular pressure * Recent major burn * Multiple trauma * Susceptibility to or family history of malignant hyperthermia

Outcomes

Primary Outcomes

Plasma Myoglobin Concentration

Time frame: induction, 5 minutes after administration, 20 minutes and 24 hours post operatively

Secondary Outcomes

Muscle Pain

verbal rating scale score and the pain score both at 2 and 24 hours postoperatively. The verbal rating scale score ranges from 0 (no pain) to 100 (worst pain imaginable). The pain score ranges from 0 to 3: 0 none; 1 muscle stiffness or pain in the nape of the neck, shoulders, and chest; 2 muscle stiffness and pain requiring analgesia; and 3 incapacitating generalized muscle stiffness or pain.

Time frame: 2 and 24 hours postoperatively

Serum Potassium Concentration

Time frame: At 5 and 20 min after succinylcholine

Change in Plasma Creatine Phosphokinase (CK) Concentration From 2 to 24 Hours Postoperatively

Change in plasma creatine phosphokinase (CK) concentration from 2 to 24 hours postoperatively

Time frame: 2 and 24 hours postoperatively

Duration of Succinylcholine Block

Time required to reach maximum block by succinylcholine after succinylcholine administration.

Time frame: intraoperative: from succinylcholine administration

Fasciculation

The fasciculation ranges from 0 to 3: 0 none; 1 small movements around eyes and fingers; 2 moderate movements in face, neck, fingers, and trunk; and 3 vigorous movements in trunk and extremities.

Time frame: postoperative