The Neuromuscular Blocking Effect of Mivacurium in Isolated Rat Phrenic-Hemidiaphragm with Long-term Phenytoin Pretreatment.
10.4097/kjae.1997.33.2.237
- Author:
Tae Gan RYU
;
Jong Sul KIM
;
Mi Kyeong LEE
;
Young Cheol PARK
;
Sang Ho LIM
;
Young Seok CHOI
;
Suk Min YOON
- Publication Type:Original Article
- Keywords:
Neuromuscular relaxants, mivacurium;
Anticonvulsants, phenytoin;
Interactions, drug
- MeSH:
4-Aminopyridine;
Animals;
Atracurium;
Drug Interactions;
Neostigmine;
Neuromuscular Blockade*;
Phenytoin*;
Pipecuronium;
Rats*
- From:Korean Journal of Anesthesiology
1997;33(2):237-242
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of metocurine, atracurium, doxacurium, and pipecuronium. This study examine neuromuscu-lar blocking effect and recovery of mivacurium in isolated rat phrenic-hemidiaphragm with two-weeks phenytoin pretreatment. METHOD: After the administration of 14 days of phenytoin 40 mg/kg, administered intraperitoneally twice daily (n=10), ED90, antagonism of neostigmine and 4-aminopyridine on the electrically evoked twitch response and train-of-four (TOF) stimulation were compared to control groups in isolated rat phrenic-hemidiaphragm preparation. RESULTS: ED90 was significantly greater in the phenytoin group than in the control group (319 +/- 39.5 g vs. 209.5 +/- 52.2 g, respectively). After the administration of neostigmine 0.75 M, the recovery of the single twitch and TOF ratio were significantly lesser in the phenytoin group than in the control group (single twitch; 19.6 +/- 6.6% vs. 69.2 +/- 9.4%, TOF ratio; 0.258 +/- 0.149 vs. 0.543 +/- 0.1, respectively). After the administration of 4-aminopyridine 40uM, the recovery of the single twitch and TOF ratio were no significant differrence between the phenytoin group and the control group (twitch; 118.1 +/- 25.3% vs. 122.6 +/- 24.8%, TOF ratio; 0.937 +/- 0.051 vs. 0.949 +/- 0.067, respectively). CONCLUSION: Long-term phenytoin therapy induces resistance to the neuromuscular blocking effects of mivacurium.
