Does the Use of Lidocaine Affect the Incidence of Succinylcholine-Based Sore Throat, Myalgia, and Fasciculation? A Double-Blind Randomized Clinical Trial

Rapid Sequence Induction and Intubation (RSII) is used when the patient is at high risk of pulmonary aspiration of gastric contents. Various side effects of succinylcholine such as sore throat, fasciculation, and myalgia led us to search for a solution to mitigate succinylcholine’s complications. The goal of this study was, therefore, to determine if the Intravenous (IV) administration of lidocaine can affect the incidence of succinylcholine-based sore throat, myalgia, and fasciculation following an appendectomy.

A clinical trial was performed in 2016 on 90 patients (aged 15-70) who were referred to Shahid Mohammadi Hospital (Bandar Abbas, Iran) for an appendectomy. Patients were randomly divided into two groups. Patients’ demographic information (e.g. age, weight, and gender) were recorded. Participants in the first and second groups received lidocaine and normal saline (NSS), respectively, immediately following RSII and shortly before succinylcholine administration. Patients were asked to survey them in terms of any sore throat, myalgia, and fasciculation symptoms. Data were analyzed using IBM SPSS Statistics 23.0, and descriptive and inferential statistics.

Fifty-five percent of the participants were male and forty-five percent were female. The mean age at the group receiving normal saline was three years more than that of the group receiving lidocaine. The incidence of sore throat was considerably lower in patients receiving lidocaine. The incidence of myalgia was nearly equal in both groups. And the rate of mild fasciculation incidence was higher in the group receiving lidocaine, while patients receiving normal saline experienced a higher rate of severe fasciculation incidence.

The use of lidocaine has no significant effect on the incidence of succinylcholine side effects such as the intensity of sore throat, myalgia, and fasciculation.