The usefulness of nondepolarizing muscle relaxants for intubation is limited by a relatively slow onset of neuromuscular block compared to that achived with succinylcholine. But, authors have reported that larger doses of nondepolarizing muscle relaxants produce a more rapid onset of maximal neuromuscular block and conditions conductive to endotracheal intubation and recent reports support the use of the "priming principle in the clinical practice of anesthesiology. This phenomenon may apply to all nondepolarizing relaxants: it is reported to facilitated neuromuscular blockade and tracheal intubation when used with atracurium, vecurouium, alcuronium or pancuronium. In this study, administering a small subclinical dose of atracurium (75ug/kg) Smin. prior to the remainder of an intubating doae of atracurium (250ug/kg) had no different on grade of block for intubation compared to single IV bolus of atracurium (500ug/kg).
Alcuronium ; Anesthesiology ; Atracurium* ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Pancuronium ; Succinylcholine

The usefulness of nondepolarizing muscle relaxants for intubation is limited by a relatively slow onset of neuromuscular block compared to that achived with succinylcholine. But, authors have reported that larger doses of nondepolarizing muscle relaxants produce a more rapid onset of maximal neuromuscular block and conditions conductive to endotracheal intubation and recent reports support the use of the "priming principle in the clinical practice of anesthesiology. This phenomenon may apply to all nondepolarizing relaxants: it is reported to facilitated neuromuscular blockade and tracheal intubation when used with atracurium, vecurouium, alcuronium or pancuronium. In this study, administering a small subclinical dose of atracurium (75ug/kg) Smin. prior to the remainder of an intubating doae of atracurium (250ug/kg) had no different on grade of block for intubation compared to single IV bolus of atracurium (500ug/kg).
Alcuronium ; Anesthesiology ; Atracurium* ; Intubation ; Intubation, Intratracheal* ; Neuromuscular Blockade ; Pancuronium ; Succinylcholine

Either tacrine (THA) with succinylcholine or alcuronium was used on a randomized basis for laparoscopic procedures in twenty young females. The technique using THA with succinylcholine was found to be more suitable and predictable for this procedure and gave a smoother anaesthetic course, brighter recovery and minimal postoperative complications.
Alcuronium - adverse effects ; Aminoacridines - adverse effects ; Anesthesia Recovery Period ; Laparoscopy - methods ; Postoperative Complications - prevention & ; control

A 41 year-old male underwent resection of a pheochromocytoma under general anesthesia. The patient was treated with phenoxybenzamine for 14 days preoperatively and premedicated with triflupromazine, diazepam, pethidine and hydroxyzine in combination. Following induction of anesthesia with intravenous morphine, thiopental sodium and alcuronium, endotracheal intubation was performed. As soon as intubation, tachycardia(143/min) and hypertension(170/100 mmHg) developed, but were controlled by intravenous injection of propranolol. Anesthesia was maintained with nitrous oxide, oxygen and enflurane, and alcuronium. Blood pressure during manupulation of tumor mass was 160/100 mmHg without arrhythmia but gradually was controlled to the range of 120-130/80-85 mmHg after intravenous infuaion of nitroglycerine at the rate of 0.5-2 ug/kg/min. After removal of the tumor mass, the blood pressure dropped to 100/70 mmHg. Blood pressure was controlled by I.V. low molecular weight dextran, and Hartmanns solution, but a vasoconstrictive agent was not needed. There was no marked tachycardia or arrhythmia during anesthesia. The importance of preoperative preparation, premedication, selection of anesthetics and nitroglycerne for controling the episodic hemodynamic pressure response is discussed.
Adult ; Alcuronium ; Anesthesia ; Anesthesia, General ; Anesthetics ; Arrhythmias, Cardiac ; Blood Pressure ; Dextrans ; Diazepam ; Enflurane ; Hemodynamics ; Humans ; Hydroxyzine ; Injections, Intravenous ; Intubation ; Intubation, Intratracheal ; Male ; Meperidine ; Molecular Weight ; Morphine ; Nitroglycerin* ; Nitrous Oxide ; Oxygen ; Phenoxybenzamine ; Pheochromocytoma* ; Premedication ; Propranolol ; Tachycardia ; Thiopental ; Triflupromazine

The effect of various drugs on the incidence and severity of hypertension, tachycardia and emergence phenomena associated with ketamine anesthesia were investigated in many studies. Lorazepam is a psychotropic agent of the benzodiazepine class. similar in action to, but more potent than, diazepam. This study was carried out to investigate the efficiency of the ketamine I.V. drip technique under endotracheal intubation with a combination of nitrous oxide, oxygen, muscle relaxant and controlled ventilation. The only contraindications to the use of this technique were hypertension, a history of cerebrovascular disease or psychotic upset. Eighteen patients, ranging in age from 20 to 60 years, were premedicated with I.M. atropine sulfate and oral lorazepam (2mg/kg) administration. Anesthesia was induced with 1.5~2,0mg/kg ketamine and 0.03~0.04mg/kg alcuronium, before intubation. Anesthesia was maintained by dripping 0. l% ketamine in 5% dextrose in water, with N2O and 02, The average dosage of ketamine was l. 685mg/kg for induction and 0.011mg/kg/min for maintenance during operations with a duration of from 55 to 275 minutes. Alcuronium is a non-depolarizing muscle relaxant and a derivative of C-toxiferine l. It has a little ganglionic blocking effect. The increase of blood pressure after endotracheal intubation was not significant. The incidence of complications of anesthesia was increased blood pressure 16. 7% (20mmHg above preop. value), tachycardia 38. 9% , dreams 5. 6 % and hallucination 5. 6%. Also oral premedication with lorazepam provided significant anterograde amnesia in all patients. It may be concluded that a combination of oral premedication by lorazepam and ketamine I.V. drip anesthesia with N2,O, O2 and alcuronium, followed by endotracheal intubation, can be used relatively satisfactorily in explo-laparatory operations in which muscle relaxation is needed.
Alcuronium ; Amnesia, Anterograde ; Anesthesia ; Anesthesia, Endotracheal* ; Atropine ; Benzodiazepines ; Blood Pressure ; Cerebrovascular Disorders ; Clinical Study* ; Diazepam ; Dreams ; Ganglion Cysts ; Glucose ; Hallucinations ; Humans ; Hypertension ; Incidence ; Intubation ; Intubation, Intratracheal ; Ketamine ; Lorazepam ; Muscle Relaxation ; Nitrous Oxide ; Oxygen ; Premedication ; Tachycardia ; Ventilation ; Water

A 21 year-old female underwent resection of a pheochrocytoma under general anesthesia. The patient was treated with phenoxybenzamine for 5 days preoperatively and premedicated with triflupromazien, Librium, Seconal, pethidine, hydroxyzine and atropine in combination. Following indution of anesthesia with intravenous morphine and thiopental sodium, succinylchoine was administered intravenously and endotracheal intubation was performed. Anesthesia was maintained with nitrous oxide, oxygen and methoxyflurane, using a semiclosed carbon dioxide absorption circle system, and alcuronium was injection intermittently. Blood pressure during manipulation of tumor was increased up to 190/130 torr without arrhythmia and transiently dropped to 70/50 torr immediately after removal. Blood pressure was controlled by i.v. Hartmann's solution and whole blood with Solucortef and Effortil but not norepinephrine was needed. There was no marked tachycardis or arrhythmia during anesthesia, so a beta-adrenergic blocker(Inderal) was not used. The importance of preoperative preparation, premedication and selction of anesthetics is discussed.
Absorption ; Alcuronium* ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Arrhythmias, Cardiac ; Atropine ; Blood Pressure ; Carbon Dioxide ; Chlordiazepoxide ; Etilefrine ; Female ; Humans ; Hydroxyzine ; Intubation, Intratracheal ; Meperidine ; Methoxyflurane* ; Morphine ; Nitrous Oxide ; Norepinephrine ; Oxygen ; Phenoxybenzamine ; Pheochromocytoma* ; Premedication ; Secobarbital ; Thiopental ; Triflupromazine*