Neuromuscular disorders (NMDs) are a heterogeneous group of neurological and muscular diseases. Patients present with typical features such as wasting and weakness of skeletal muscles. However, despite these common clinical signs, underlying etiologies are nearly as multifaceted as the number of the diseases. For the anesthesiologist, it is very important to know the origin of a particular dise...

To the Editor:—Schreiber et al. noted an association between larger doses of succinylcholine and a reduced incidence of fasciculation and myalgia. However, pretreatment with a nondepolarizing neuromuscular blocker is also associated with a reduced risk of fasciculation and myalgia. It is a common practice for clinicians to use a larger dose of succinylcholine when they have provided pretreatmen...

PURPOSE Two cases of malignant hyperthermia suspected to be related to the use of a nondepolarizing neuromuscular blocker are reported. SUMMARY A pharmacogenetic disorder that may occur in as many as 1 in 3000 anesthesia procedures, malignant hyperthermia has been linked to the use of certain anesthetic gases and depolarizing neuromuscular blocking agents (e.g., succinylcholine). Although non...

To the Editor:—Schreiber et al. noted an association between larger doses of succinylcholine and a reduced incidence of fasciculation and myalgia. However, pretreatment with a nondepolarizing neuromuscular blocker is also associated with a reduced risk of fasciculation and myalgia. It is a common practice for clinicians to use a larger dose of succinylcholine when they have provided pretreatmen...

To the Editor:—Schreiber et al. noted an association between larger doses of succinylcholine and a reduced incidence of fasciculation and myalgia. However, pretreatment with a nondepolarizing neuromuscular blocker is also associated with a reduced risk of fasciculation and myalgia. It is a common practice for clinicians to use a larger dose of succinylcholine when they have provided pretreatmen...

BACKGROUND AND OBJECTIVES Neuromuscular blockers (NMB) have been used for more than half of a century in anesthesia and have always been a challenge for anesthesiologists. Until recently, the reversal of nondepolarizing neuromuscular blockers had only one option: the use of anticholinesterase agents. However, in some situations, such as deep neuromuscular blockade after high doses of relaxant, ...

The effect of carbon dioxide on the neuromuscular blocking effect of the non-depolarizing muscle relaxants tubocurarine and gallamine has been known for some time. Kalow (1954) noted that the action of tubocurarine on an isolated muscle preparation was increased by lowering the pH. Payne (1958) found that in the anaesthetized cat the activity of tubocurarine was increased with a reduction of pH...

IN vitro experiments at room temperature with benzoylcholine as a substrate showed that 10–50 mM fluoride, the concentration usually observed with sevoflurane anesthesia, inhibits pseudocholinesterase (PChE) by 16– 56%. PChE is the enzyme responsible for the metabolism of mivacurium. Mivacurium dose requirements to maintain neuromuscular blockade are decreased by sevoflurane. In addition to the...

Several topics of current interest in the field are currently undergoing evolution. Since we are living and practicing in the midst of this change, there is controversy surrounding the adaptation of new concepts and procedures into clinical practice. This lecture will discuss the following areas of current discussion. 1 The "priming" technique, onset of neuromuscular blockade, rapidity of intub...