الفهرس 
acknowledgmentOnly 14 pages are availabe for public view
 |  | from | 122 |  |  |
| | | from | 122 | | |
Abstract
This work was carried out on 50 adult patients of either sex selected from patients admitted to Main Alexandria University Hospital. The patients were free from metabolic, cardiovascular or respiratory diseases and were scheduled for superificial surgery. They recieved nothing per os 6-8 hours before operation and no intramuscular injections were given to avoid trauma to the muscles with consequent changes in the parameters urier study.
Ereanaesthetic medication was in the form of 1 mg atropine sulphate intravenously 10 minutes before induc¬tion, anaesthesia was induced by an intravenous 2.5 per cent thiopentone sodium in a dose of 5-7 mgKg” body weight followed by suxamethonium 1.2 mgKg body weight oxygenation then atraumatic endotracheal intubation was done and connected to Boyle’s machine via a semiclosed icirciut.
Patients were divided into two groups fifteen each, the first group recieved d-tubocurarine in a dose of 0.O5 mgKg”* body weight 2-3 minutes prior to suxamethonium and served as control, the second group recieved no j>re-treatment bai’ojv suxamethonium, maintainance of anaesthe¬sia was carried out using a balanced anaesthetic technique;
oxygen:nitrous oxide in the ratio of (3:7) supplemented with 0.5-1% fluothane with assisted respiration. Non depolarizers were given when needed after restoration of spontaneous respiration after suxamethonium.
Fasciculations after suxamethonium were observed and its degree was recorded. Serum creatinine phosphokinase, potassium, sodium, calcium, and phosphorus were determined first prior to induction and after 5»10 and 15 minutes following suxamethonium administration.
In the postoperative period patients were asked about the types of postoperative pain, onset, site, duration, localised or generalised and wether it is associated with stiffness or not.
The results obtained showed that suxamethonium in group II produced significant increase in serum creatinine phosphokinase after 5 minutes (t= 4.005) 10 minutes (t= 5.169) and 15 minutes (t= 6.165) following its administ¬ration. Suxamethonium produced significant rise in serum, potassium 5 minutes (t= 3.078), 10 minutes (t= 3*303) and 15 minutes (t= 10.256) following its intravenous administra¬tion in group II.
Suxamethonium in group II produced insignificant decrease in serum sodiuui 5 minutes (t= 0.976) and 10 minutes (t= 0.089) following its administration while produced
significant decrease in serum sodium after 15 minutes (t= 3.5«8).
Suxamethonium in group II produced significant hypoca-lcaeiaia after 5 minutes (t= 2.895), 10 minutes (t= 3.172) and 15 minutes (t= 6.236) following suxamethonium. Suxame¬thonium produced insignificant changes in serum phosphorus after 5 minutes (t= 1.118), 10 minutes (t= 0.496) and 15 minutes (t= 0.928) following its administration in group II. D-tubocurarine was very effective in the relief of fascicula-tions caused by suxamethonium, d-tubocurarine prior to suxa¬methonium in the control group (I) produced insignificant increase in serum creatinine phosphokinase after 5 minutes (t= 1.792), 10 minutes (t= 1.851) and significant increase after 15 minutes (t= 2.759) following suxamethonium. In control group (I) suxamethonium produced insignificant rise in serum potassium 5 minutes (t= 1.176), 10 minutes(t=0.652) and 15 minutes (t=0.451) following its administration, and produced insignificant changes in serum sodium 5 minutes (t=0.119), 10 minutes (t=0.651) and 15 minutes (t=2.13l) after suxamethonium,and produced significant hypocalcaemia after 5 minutes (t=2.547),10 minutes (t=2.793)and 15 minutes (t=2.46) while produced insignificant increase in serum phosphorus 5 minutes (t=1.625), 10 minutes (t=l.l) and 15 minutes (t= 1.655) following its administration.
D-tubocurarine prior to suxamethonium in control group(I) was
very effective in the amelioration of postoperative myalgia as evidenced by reduction in the incidence of postoperative pain to 20% and the patients were calm and easly ambulated so avoiding the postoperative complications of prolonged bed rest.