The Effect of Defasciculating Doses of Pancuronium and Atracurium on Succinylcholine Neuromuscular blockade
| Autor: | C. Motamed, Duvaldestin Philippe |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Elective orthopaedic surgery
Neuromuscular Blockade business.industry medicine.drug_class Brief Report Anova test Succinylcholine Muscle relaxant Neuromuscular monitoring Blockade Fasciculation Anesthesiology and Pain Medicine Anesthesia Atracurium Paralysis medicine Pancuronium medicine.symptom business |
| Zdroj: | Anesthesiology and Pain Medicine |
| ISSN: | 2228-7531 2228-7523 |
| DOI: | 10.5812/aapm.18488 |
| Popis: | Background: A defasciculating dose of non-depolarizing muscle relaxant administered prior succinylcholine decrease its side effects including fasciculations and postoperative myalgias; however it is believed that the dosage of succinylcholine should be increased when such a pre-treatment is used. Objectives: We hypothesized that a defasciculating dose of pancuronium as a pre-treatment could prolong its duration of effect. Patients and Methods: Forty patients scheduled for elective orthopaedic surgery were consecutively assigned into 5 groups, a first group without pre-treatment (succinylcholine 1 mg/kg) and 4 subsequent groups of pretreatment with atracurium 0.05 mg/kg + succinylcholine 1 or 1.5 mg/kg and pancuronium 7.5 µg /kg + succinylcholine 1 and 1.5 mg/kg. The muscle relaxant effect of succinylcholine was assessed with a force transducer using train of four stimulations every 12 seconds. Kruskall Wallis Anova test was used to compare results. Results: The duration of succinylcholine induced paralysis (1 and 1.5 mg/kg) was significantly prolonged with pre-treatment with pancuronium but succinylcholine 1mg/kg did not reached maximum blockade after pre-treatment with atracurium. After pancuronium, full recovery after succinylcholine 1.5 and 1 mg/kg occurred respectively after 18 and 15 minutes. P < 0.05 vs. 12 minutes for succinylcholine 1mg/kg alone. Conclusions: This study highlights potentiation effect of a defasciculating dose of pancuronium on succinylcholine paralysis suggesting the lack of justification to increase succinylcholine dosage. |
| Databáze: | OpenAIRE |
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