The Effects of Anesthesia on Serum Myoglobin and CPK

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I have studied the effects of intravenous injection of succinylcholine (SCC) on serum levels of myoglobin (Mb) and CK in 75 children. They were divided into seven groups ; In Group HS, ES, ST2, ST4 and SL, 1mg/kg of SCC was injected intravenously before intubation. In Group H and E, intubation was performed without SCC. In Group ST2 and ST4, thiopental 2mg/kg or 4mg/kg was injected and in Group SL, lidocaine 2 mg/kg was injected prior to the injection of SCC. Anesthesia was induced and maintained with nitrous oxide, oxygen and halothane in Group HS, H, ST2, ST4 and SL, enflurane in Group SE and E, respectively. Blood samples were drawn before and at 5, 20 and 60 min after the injection of SCC. Mb was analyzed by RIA technique and CK was by a modification of Rosalki's method.In Group HS and ES, Mb and CK values values increased remarkably (60 min value, mean <plus-minus> SE : Mb-Group HS ; 2192 <plus-minus>639 ng/ml, Group ES ; 1722<plus-minus>436 ng/ml, CK-Group HS ; 174.1<plus-minus>32.9 IU/l, Group ES ; 193.6 <plus-minus>35.7 IU/l). Though Mb values increased in Group H (40 <plus-minus>12ng/ml) and Group E (43 <plus-minus>9 ng/ml), they were significantly less than Group HS and ES, and CK values in increased neither groups. In the two thiopental injected groups, the increase in values was significantly less in Group ST4 (Mb : 685<plus-minus>140 ng/ml, CK : 114.0<plus-minus>15.7 ng/ml) than Group ST2 (Mb : 1932<plus-minus>478 ng/ml, CK : 251.2<plus-minus>57.7 ng/ml) and no significant difference was found between Group ST2 and Group HS. In Group SL, Mb and CK values increased (Mb : 1536<plus-minus>679 ng/ml, CK : 174<plus-minus>39.2ng/ml) and significant difference was notThese results indicate that the increase of values is mainly induced by SCC, and though thiopental 4mg/kg is effective to suppress the increase, 2mg/kg is not. Lidocaine is not considered to increase the values and is thought to be used on patient of myoglobinuria.