Effect of Infusion of Dexmedetomidine on Succinylcholine-induced Fasciculation and Myalgia in ENT Surgeries: A Research Protocol

Introduction: Succinylcholine, a depolarising neuromuscular blocker, is widely used to facilitate rapid sequence intubation due to its rapid onset and short duration of action. However, it is associated with adverse effects, including transient elevations in Intraocular Pressure (IOP), which can be harmful in patients with ocular trauma or glaucoma. Need of the study: Several pharmacologic agents have been studied to attenuate these IOP changes, with mixed efficacy and potential side-effects. Dexmedetomidine, a selective α2- adrenergic agonist with sedative, analgesic, and sympatholytic properties, has shown promise in attenuating sympathetic responses during laryngoscopy and intubation. Therefore, further investigation is warranted in this clinical setting. Aim: To evaluate the efficacy of dexmedetomidine premedication in reducing succinylcholine-induced fasciculations and myalgia during general anaesthesia in patients undergoing elective Ear, Nose and Throat (ENT) surgeries. Materials and Methods: The present randomised, double-blind control trial will be conducted in the Department of Anaesthesia, Acharya Vinoba Bhave Rural Hospital, a unit of Jawaharlal Nehru Medical College (DMIHER), Sawangi, Wardha, Maharashtra, India, over a period from July 2024 to June 2026. The study will include patients scheduled for elective surgeries under general anaesthesia. Patients will be randomly assigned to one of two groups: the study group, which will receive intravenous dexmedetomidine premedication (0.5 µg/kg), and the control group, which will receive normal saline. Standard anaesthesia protocols will be followed in both groups, and succinylcholine will be administered to facilitate intubation. IOP, Heart Rate (HR), and blood pressure will be recorded at baseline, after study drug administration, after succinylcholine injection, and following intubation. Data will be analysed using t-test, Chi-square test, and repeated-measures Analysis of Variance (ANOVA), with p<0.05 considered significant.