Background: Succinylcholine is widely used for rapid sequence induction due to its rapid onset and short duration of action. However, its use is commonly associated with adverse effects such as muscle fasciculations and postoperative myalgia. Pretreatment with nondepolarizing neuromuscular blocking agents has been proposed as an effective strategy to attenuate these complications.

Objective: To evaluate and compare the effectiveness of rocuronium and cisatracurium pretreatment in reducing succinylcholine-induced fasciculations and postoperative myalgia.

Methods: This prospective, randomized study included 150 patients undergoing elective surgeries under general anesthesia. Patients were equally divided into three groups: saline (control), cisatracurium, and rocuronium (n=50 each). Fasciculations were assessed following succinylcholine administration. Postoperative myalgia was evaluated in the post-anesthesia care unit (PACU) and at 24 hours. Statistical analysis was performed using appropriate tests, with p<0.05 considered significant.

Results: Baseline characteristics were comparable across groups. Rocuronium significantly reduced fasciculations, with 82% of patients showing no fasciculations compared to 28% in the saline group (p<0.001). Cisatracurium did not show a statistically significant effect. Rocuronium also significantly reduced postoperative myalgia at PACU (p<0.001) and at 24 hours (p=0.012), whereas cisatracurium showed no significant benefit.

Conclusion: Rocuronium pretreatment is more effective than cisatracurium in reducing succinylcholine-induced fasciculations and postoperative myalgia, making it a preferable option in clinical anesthesia practice.

KEYWORDS: Succinylcholine, Rocuronium, Cisatracurium, Fasciculations, Postoperative Myalgia, Randomized Controlled Study.