Summary
The effects of pretreatment with both sub-paralyzing and paralyzing doses of pancuronium and d-tubocurarine, on the onset and duration of succinylcholine-induced neuromuscular blockade were evaluated and compared in 225 patients. D-tubocurarine antagonized both onset and duration of succinylcholine block, while pancuronium produced a dual effect, antagonizing the onset and potentiating the duration of succinylcholine block. Pretreatment with d-tubocurarine (0.07 mg/kg, 0.3 mg/kg and 0.6 mg/kg) increased the time to onset of succinylcholine paralysis from 28 to 118 per cent, and decreased the duration from 16 to 37 per cent. Pancuronium (0.02 mg/kg, 0.04 mg/kg and 0.08 mg/kg) also antagonized the onset of succinylcholine paralysis with increases of 32 to 114 per cent, but potentiated its duration from 30 to 103 per cent compared with succinylcholine alone in the same patients. Although pancuronium markedly inhibited serum cholinesterasein vitro (I50 = 5 x 10-7 mol) there was only a 10 per cent inhibition of cholinesterasein vivo after pancuronium 0.0S mg/kg.
Résumé
Les effets ďune injection préalable de d-Tubocurarine et de Pancuronium (à doses paralysantes et à doses inférieures ) sur la rapidité ďaction et sur la durée du bloc neuro-musculaire produit par la Succinylcholine, ont fait ľobjet de cette étude qui a porté sur 225 patients.
La d-Tubocurarine retardait ľapparition et raccourcissait la durée ďaction du bloc à la Succinylcholine. Le Pancuronium avait un double effet, à savoir: un retard à ľapparition du bloc à la Succinylcholine et une potentialisation de sa durée.
Des doses de 0.3, de 0.6 et de 0.7 mg/kilo en d-tubocurarine, injectées avant une dose de Succinylcholine retardaient ľapparition de paralysie à la Succinylcholine de 28 à 118 pour cent et diminuaient la durée de son effet de 16 à 37 pour cent.
Le Pancuronium à des doses de 0.02, 0.04 et 0.08 mg/kilo retardait également ľapparition de la paralysie à la Succinylcholine de 32 à 114 pour cent mais augmentait sa durée de 30 à 103 pour cent.
Bien que le Pancuronium montrait une inhibition marquée de la cholinestérase sérique,in vitro, on ne retrouvait qu’une diminution de 10 pour cent,in vivo, ceci après une dose de 0.08 mg/kilo.
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Ivankovich, A.D., Sidell, N., Cairoli, V.J. et al. Dual action of pancuronium on succinylcholine block. Canad. Anaesth. Soc. J. 24, 228–242 (1977). https://doi.org/10.1007/BF03006236
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DOI: https://doi.org/10.1007/BF03006236