Summary
Brevatonal and Mediatorial are two synthetic curare-like preparations used in Europe since 1952.
Brevatonal belongs to the leptocurare group, but compared to succinylcholme its action is slower and more prolonged. Its latent period is from one to three minutes, and its average duration is twenty minutes. It combines with thiobarbital without causing precipitation, and repeated doses do not have cumulative effect.
Mediatonal has a rapid and prolonged action. It brings into play, by trigger action, changes in the electrical potential of thiobarbital, the leptocurares to the extent of 300 per cent, and the pachycurares 1000 per cent. It is non-toxic, but has a cumulative action if the doses are repeated within thirty-minute intervals.
The electrical potential mediator property is used in the Brevatonal-Mediatonal combination in order to reduce, to an appreciable extent, the dosage of the curare-like substance, as well as the anaesthetics.
We have used these preparations 106 times for various operative procedures. Special attention was given to their use in the more common types of operations, such as cholecystectomies, appendectomies, and tonsillectomies. There are certain features which are worth noting.
A depolarization block due to Brevatonal is never accompanied by much fasciculation, even when administered prior to Pentothal induction. Respiratory depression was never very marked in our experience; and intubation was never a problem. In our opinion, this relaxant, as a curare-like agent of relatively long duration, should occupy an intermediate place between succinylcholine and decamethonium.
With Mediatonal alone, satisfactory muscular relaxation can be obtained with a fairly large dose; the association of Brevatonal and Mediatonal, however, procures long anaesthesia with relatively small doses of the curare-like substance when complementary anaesthetics are used.
Brevatonal fills a gap in the duration pattern, between succinylcholine and the curare-like substances of longer duration, it is admirably suited for operations that are neither too long nor too short, and especially suitable when intubation or muscular relaxation are required.
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Allard, E., Patoine, J.G. Considerations cliniques sur Ľemploi de deux nouveaux curarisants de synthese le brevatonal et le mediatonal. Can Anaes Soc J 3, 357–362 (1956). https://doi.org/10.1007/BF03015279
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DOI: https://doi.org/10.1007/BF03015279