Edrophonium and human plasma cholinesterase combination for antagonism of mivacurium-induced neuromuscular block
| Autor: | Ahmed Turkistani, Mohamed Naguib, Saleh W. Alharby, A. H. Samarkandi, H S Bakhamees |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Adolescent Neuromuscular Junction Edrophonium Fentanyl Cholinesterases Humans Medicine Ulnar nerve Butyrylcholinesterase Cholinesterase biology business.industry Antagonist Drug Synergism Middle Aged Isoquinolines Adductor pollicis muscle Mivacurium Anesthesiology and Pain Medicine Isoflurane Anesthesia biology.protein Female Cholinesterase Inhibitors business Neuromuscular Nondepolarizing Agents medicine.drug |
| Zdroj: | British Journal of Anaesthesia. 77:424-426 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/77.3.424 |
| Popis: | We have compared the reversal characteristics of mivacurium after administration of an edrophonium-plasma cholinesterase (PCHE) combination with that produced by each antagonist alone. Forty ASA I adults were given mivacurium 0.15 mg kg-1 during fentanyl-thiopentone-nitrous oxide-isoflurane anaesthesia. TOF stimulation was applied to the ulnar nerve every 12 s, and the force of contraction of the adductor pollicis muscle was recorded. When spontaneous recovery of first twitch height (T1) reached 10% of its initial control value, patients were allocated randomly to one of four groups (n = 10 in each). Neuromuscular function in patients in group 1 (control group) was allowed to recover spontaneously. Patients in groups 2-4, respectively, received edrophonium 1 mg kg-1 (group ED), exogenous PCHE equivalent to activity present in 25 ml kg-1 of human plasma (group PCHE) or edrophonium 1 mg kg-1 with exogenous human PCHE equivalent to the activity present in 25 ml kg-1 of human plasma (combination group). The time to attain a TOF ratio of 0.75 in the combination group was 4.6 (SD 0.9) min. This was shorter (P0.01) than that observed in patients in the control (16.8 (3.3) min), ED (8.9 (3.6) min) and PCHE (9.3 (1.6) min) groups. There was no difference in recovery indices between groups ED and PCHE. We have demonstrated that the edrophonium-PCHE combination significantly accelerated recovery of mivacurium-induced block compared with that observed with the use of individual antagonists. |
| Databáze: | OpenAIRE |
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