No abstract available.
Larynx* ; Pharmacology ; Succinylcholine* ; Vecuronium Bromide*

The interaction between succinylcholine (SCC) and non-depolarizers, atracurium or vecuronium was investigated in 36 cats of either sex using the sciatic nerve-anterior tibialis muscle preparation. Additionally, the relation of SCC to pseudocholinesterase activity was examined. The duration of action of vecuronium (6.5 +/- 1.3 to 7.3 +/- 2.2 minutes) in cats pretreated with SCC was greater than those (2.0 +/- 0.6 minutes) in non-pretreated cats. However, SCC had no influence on the duration of atracurium. The serum pseudocholinesterase activity was decreased after the injection of atracurium or neostigmine in contrast to vecuronium. The authors conclude that the prior administration of SCC prolongs the duration of vecuronium but not that of atracurium, and pseudocholinesterase activity is not related to the prolonging effect of SCC.
Animal ; Atracurium/*pharmacology ; Cats ; Female ; Male ; Succinylcholine/*pharmacology ; Vecuronium Bromide/*pharmacology

OBJECTIVETo study the pharmacodynamics of vecuronium,atracurium, mivacurium and rocuronium in patients with end-stage renal failure.

METHODSForty-six patients with end-stage renal failure scheduled for renal transplantation and 53 patients with normal renal function were given either vecuronium, atracurium, mivacurium or rocuronium. The neuromuscular effects were monitored by the evoked response of the adductor pollicis to train-of-four stimulation of the ulnar nerve.

RESULTSOnset of vecuronium, atracurium and mivacurium occurred faster or tended to be faster in patients with end-stage renal failure, but there was no significant difference in onset by rocuronium between the control patients and renal failure patients. Furthermore, the no-response period, duration of action and recovery of atracurium did not differ between the two groups. There was no significant difference in duration of action or recovery of mivacurium between the two groups, whereas its no-response period was significantly prolonged in the patients with end-stage renal failure. There was no difference in no-response period or duration of action after the initial dose of vecuronium or rocuronium between the two groups. However, no-response period and duration of effect by vecuronium and rocuronium were prolonged with increasing incremental doses in patients with end-stage renal failure.

CONCLUSIONSAll four muscle relaxants could be safely used in patients with end-stage renal failure. Onset of the relaxants were, in some cases, accelerated and no-response period of mivacurium was prolonged in patients with end-stage renal failure undergoing dialysis therapy. End-stage renal failure prolonged the no-response period and duration of action of vecuronium and rocuronium after repeated incremental doses, but did not alter those attributed to atracurium.

Adult ; Androstanols ; pharmacology ; Anesthesia, General ; Atracurium ; pharmacology ; Female ; Humans ; Isoquinolines ; pharmacology ; Kidney Transplantation ; Male ; Middle Aged ; Neuromuscular Blocking Agents ; pharmacology ; Succinylcholine ; pharmacology ; Time Factors ; Vecuronium Bromide ; pharmacology

BACKGROUND: The actions of mivacurium (MVC), a new benzylisoquinolinium nondepolarizing neuromuscular blockade, may be potentiated if preceded by succinylcholine (SCh). Additionally, the interaction between inhalational anesthetics and MVC has not yet been established in the cat. The effect of enflurane or isoflurane on the neuromuscular blocking action of MVC by preadministrated succinylcholine was evaluated. METHOD: Twelve cats, either sex, were assigned into two groups, based on the preadministration of succinylcholine (SCh) what about the sciatic nerve-anterior tibialis preparation, cumulative dose-response study and the estimation of recovery profiles from the twitch depression of about 95 % under pentobarbital, isoflurane or enflurane anesthesia was done. The ED50, ED95 and the recovery profiles were compared. RESULTS: The ED50 and ED95 under isoflurane (24.5 & 37.3) and enflurane (20.6 & 32.1) were significantly lower than those under pentobarbital anesthesia(28.4 & 42.9 ug/kg, respectively) without preadministrated SCh. The effective doses of MVC with preadministrated SCh had the same manner. The recovery profiles under enflurane anesthesia were significantly slower than those under pentobarbital anesthesia. The higher the recovered twitch height under enflurane anesthesia, the slower the recovery speed. CONCLUSION: The potency of MVC and recovery profiles under inhalation anesthetics are greater than those under pentobarbital. However, preadministrated SCh causes no significant difference in its potency or recovery.
Anesthesia ; Anesthetics ; Anesthetics, Inhalation ; Animals ; Cats* ; Depression ; Enflurane* ; Isoflurane* ; Neuromuscular Blockade* ; Pentobarbital ; Pharmacology ; Succinylcholine*

The neuromuscular and hem+odynamic effects of mivacurium 0.15 mg/kg and succinylcholine 1 mg/kg were compared in 26 adult patients (ASA I and II) during nitrous oxide-oxygen-propofol-fentanyl anesthesia. Neuromuscular block was monitored by recording the compound electromyogram of the hypothenar muscle resulting from supramaximal train-of-four stimuli applied to the ulnar nerve. Time to onset of over 95% block and duration to 25% recovery of control twitch after injection of mivacurium were significantly longer than for succinylcholine (201 +/- 37.6 vs 54 +/- 5.2 sec and 13.0 +/- 2.2 vs 8.4 +/- 2.1 min; mean +/- SD). Onset of mivacurium with priming technique was shortened (125 +/- 20.7 sec), but was also slower than that of succinylcholine. Although the recovery index during spontaneous recovery was significantly longer for mivacurium than for succinylcholine (6.9 +/- 1.3 vs 5.1 +/- 0.9 min), antagonism with neostigmine at 25% recovery of twitch height sufficiently facilitated the recovery index of mivacurium (4.5 +/- 1.0 min) to a level similar to that of succinylcholine with no statistical difference. The hemodynamic effects of mivacurium were few as compared to those of succinylcholine. In conclusion, mivacurium is considered to have additional advantages for short procedures when succinylcholine is undesirable.
Adult ; Anesthesia ; Female ; Fentanyl/administration & dosage ; Hemodynamics/*drug effects ; Humans ; Isoquinolines/*pharmacology ; Male ; Neuromuscular Junction/*drug effects ; Neuromuscular Nondepolarizing Agents/*pharmacology ; Nitrous Oxide/administration & dosage ; Propofol/administration & dosage ; Succinylcholine/*pharmacology

We had a 52-year-old male presented for a surgery for old fracture of the 7th cervical vertebra. Generalized muscle rigidity and high fever with tachycardia was revealed 25 minutes after succinylcholine and enflurane administration. Then the body temperature was risen from 37.8 degrees C to 40.5 degrees C within 20 minutes and the arterial blood gas analysis showed a severe respiratory and metabolic acidosis. Under the suspicion of malignant hyperthermia, all anesthetics were discontinued, refrigerated intravenous solutions were started, and gastric lavage with cold saline was initiated together with packing the body with ice. Oral dantrolene 125mg, the only drug we could obtain, was administered through Levins tube after lavage. Serial serum CPK level were 4414 IU/L on third day and 74 IU/L on seventh day postoperatively. The postoperative course was uneventful and the patient could be walked after fifth day postoperatively and discharged without any sequelae.
Acidosis ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Blood Gas Analysis ; Body Temperature ; Dantrolene ; Enflurane ; Fever ; Gastric Lavage ; Humans ; Ice ; Male ; Malignant Hyperthermia ; Middle Aged ; Muscle Rigidity ; Pharmacology ; Spine ; Succinylcholine ; Tachycardia ; Therapeutic Irrigation