T h : antagonism between tubocurarine and alcuronium chloride on the one hand and neostigmine, physostigmine, edrophonium and ambenonium on the other have been investigated. A quantitative measure of antagonism was obtained on the rat diaphragm preparation and it was found that in general the antagonists were more effective against alcuronium chloride than against tubocurarine. The antagonist d...

I read with keen interest the article by Imani et al. (1) in which the authors compare tracheal intubating conditions following intravenous (IV) administration of remifentanil 5 μg/kg or alfentanil 50 μg/kg followed by induction of anesthesia with propofol 2 mg/kg in 100 adult patients premedicated with IV midazolam 1 mg. Intubating conditions were assessed (scoring 1 to 4) by ease of laryngosc...

Rocuronium and vecuronium, two non-depolarizing neuromuscular blockers, have been widely used in surgery procedures. However, their electrophysiological properties need to be more widely explored. We examined the effects of rocuronium and vecuronium on initial rundown of endplate potential amplitudes in the non-uniform stretched muscle preparation of the rat isolated phrenic nerve diaphragm. Mo...

The effect of pretreatment with suxamethonium, gallamine or pancuronium on suxamethonium-induced fasciculations and myalgia was studied in a controlled, randomized and double-blind clinical trial. Both fasciculations and myalgia were assessed on a four-point rating scale. There was no significant correlation between fasciculations and postoperative muscle pain at 24, 48 or 72 h, and pretreatmen...

We have evaluated in 10 anaesthetized patients the time course of action, infusion requirements, reversibility and pharmacokinetics of Org 9487. Org 9487 was administered as a bolus dose of 1.5 mg kg-1, followed by an infusion to maintain a block of 75-85% for 60 min. After recovery from the bolus dose, a mean dose of Org 9487 3.4 (SD 1.0) mg kg-1 h-1 was administered to maintain a mean neuromu...

Neuromuscular blocking agents (NMBAs) have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and a...

BACKGROUND Our aim was to determine whether anaesthetists routinely confirm their ability to ventilate a patient's lungs by a facemask before the administration of a neuromuscular blocker and the rationale for this practice. METHODS An online survey of trainee and non-trainee anaesthetists working in hospitals forming part of the Central London School of Anaesthesia collected 136 complete dat...

PURPOSE OF REVIEW Sugammadex is a novel drug that binds selected neuromuscular blocking drugs and prevents them from acting at the neuromuscular junction. Due to its rapid onset and relative lack of side effects, this drug promises to change the method of anesthesia delivery. This review summarizes the literature on the drug and addresses some of the potential changes that it may bring. RECEN...

A significant reduction was noticed in the amount of vecurenium needed to maintain steady neuromuscular blockade at 20% twitch height (Tl> in patients given nicardipine intraoperatively. Bolus ajection of either nicardipine or d.iltlazem during constant infusion of yecuronium produced transient depression of Tl and the train-offour ratio CTOFR). Reversal of neuromuscular blockade wtth a choline...

Curare, a selective skeletal muscle relaxant, has been used clinically to reduce shivering and as an anesthetic auxiliary in abdominal surgery. It is also widely used in animal experiments to block neuromuscular junction activity. Effective doses of curare diminish muscle contraction without affecting brain function, but at higher doses it is known to be lethal. However, the exact dose of curar...