Effects of Pseudocholinesterase and/or Neostigmine, Pyridostigmine, Edrophonium and Galanthamine for Reversal of Mivacurium- or Succinylcholine-induced Paralysis in Vitro.
10.4097/kjae.2000.39.2.232
- Author:
Sam Soon CHO
1
;
Si Ne YOON
;
Yoon CHOI
;
Hong Seuk YANG
;
Sung Min HAN
;
Sung Youl KIM
;
Byung Te SUH
Author Information
1. Department of Anesthesiology, Asan Medical Center, College of Medicine, University of Ulsan.
- Publication Type:In Vitro ; Original Article
- Keywords:
Antagonist, neuromuscular relaxants: edrphonium, galanthamine, neostigmine, pyridostigmine;
Enzyme: pseudocholinesterase;
Neuromuscular relaxants: mivacurium, succinylcholine
- MeSH:
Animals;
Baths;
Cholinesterase Inhibitors;
Edrophonium*;
Galantamine*;
Hydrolysis;
Neostigmine*;
Oxygen;
Paralysis*;
Phrenic Nerve;
Pseudocholinesterase*;
Pyridostigmine Bromide*;
Rats;
Rats, Sprague-Dawley;
Succinylcholine
- From:Korean Journal of Anesthesiology
2000;39(2):232-242
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The hydrolysis of mivacurium and succinylcholine is impaired in the presence of defects of pseudocholinesterase. Clinical reports are conflicting as to the utility of anticholinesterases, in the reversal of mivacurium- or succinylcholine-induced paralysis. In this study, the role of exogenous bovine pseudocholinesterases (BpChE) and/or neostigmine, pyridostigmine, edrophonium or galanthamine in the reversal of mivacurium- or succinylcholine-induced paralysis, were investigated with the rat phrenic nerve-diaphragm preparation. METHODS: Ninety five Sprague-Dawley rats (200 g, male) were divided into 14 groups (n = 10). The phrenic nerve-diaphragm preparation mounted in a bath containing oxygenated Krebs' solution. Twitch response from diaphragmatic muscle evoked by phrenic nerve stimulation were measured. After stabilization of the twitch responses, mivacurium (0.1 microgram/mlml) or succinylcholine (0.1 microgram/ml) was administered incrementally in the preparation to obtain more than 95% twitch inhibition. BpChE (0.1, 1.0 u/ml), and/or neostigmine (0.1, 1.0 microgram/ml), pyridostigmine (0.5, 5 microgram/ml), edrophonium (0.01, 0.1 microgram/ml) or galanthamine (0.1, 1.0 microgram/ml) were added for the reversal of mivacurium- and/or succinylcholine-induced block in each group and the twitch responses (0.1 Hz) were monitored for 60 min. The effect of BpChE (0.1 u/ml), in combination with each of the above four anticholinesterases at lower concentrations also were examined. Twitch heights more than 75% was considered an adequatereversal. RESULTS: BpChE 0.1 and 1.0 u/ml were effective in reversal of mivacurium-induced paralysis. When anticholinestrases were added, there was no effective improvement of twitch height at the end of 60 minutes. In succinylcholine-induced paralysis, BpChE was effective for reversal, but when anticholinesterases were added, BpChE potency was inhibited. CONCLUSIONS: BpChE will reverse mivacurium-induced block more effectively than anticholinesterase. BpChE is effective in reversing succinylcholine block. The addition of anticholinesterases inhibits the activity of pseudocholinesterase.
