Abstract
Forty-four patients, ASA physical status I or II, undergoing thiamylal, fentanyl,N2O/O2 anaesthesia were studied to determine the dose-response to succinylcholine (Sch) without prior defasciculation (24 pt —Group I), or three minutes following d-tubocurarine (dTC), 0.043 mg · kg−1 (20 pt —Group 2). The individual log dose-logit response curve for each patient was determined using a cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle. The mean (±SEM) ED50, ED90 and ED95 values for Sch in Group I were 0.13 ±0.01, 0.19 ±0.01 and 0.22 ±0.01 mg · kg−1, and in Group 2 were 0.16 ±0.01, 0.25 ±0.01 and 0.29 ±0.02 mg · kg−1, respectively. The mean ED values in Group 2 were significantly greater than the equivalent values in Group 1 (P < 0.05). Compared with values in Group I, ED values in Group 2 represented mean increases of 23, 32, and 32 per cent, respectively. These pharmacodynamic data indicate that the dose of Sch needs to be increased by 32 per cent following a defasciculating dose of dTC 3 mg · 70 kg−1 (0.043 mg · kg−1).
Résumé
Lors d’ une anesthésie au thiamylal, fentanyl et N2O, nousavons évalué la courbe dose-réponse de la succinylcholine (Sch) de 24 patients sans précurarisation (groupe 1) et celle de 20 autres, trois minutes après l’injection de 0,043 mg · kg−1 de d-tubocurarine (groupe 2). Les mesures individuelles combinaient le logarythme de la dose cumulative (infusion continue) au logit de la dépression de l’EMG du premier muscle interosseux dorsal. Les DE50, DE90 et DEg95 (moyenne ±erreur-type) de la Sch étaient respectivement dans le groupe I de: 0,13 ±0,01, 0,19 ±0,01 et O,22 ±0,01 mg · kg−1 alors que dans le groupe 2 elles étaient de: 0,16 ±0,01, 0,25 ±0,01 et O,29 ±0,02, supérieures done à celles du groupe 1 de 23, 32 et 32 pour cent respectivement (P < 0,05). Grâce à cette étude pharmacodynamique, on voit qu’il faut augmenter la dose de Sch de 32 pour cent si on la fait précéder d’une dose de 3 mg · 70 kg (0,043 mg · kg−1) de d-tubocurarine.
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Eisenkraft, J.B., Mingus, M.L., Herlich, A. et al. A defasciculating dose of d-tubocurarine causes resistance to succinylcholine. Can J Anaesth 37, 538–542 (1990). https://doi.org/10.1007/BF03006322
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DOI: https://doi.org/10.1007/BF03006322