Korean J Anesthesiol.  1987 Oct;20(5):637-642. 10.4097/kjae.1987.20.5.637.

Effects of Anticholinesterases on the Neuromuscular Blocking Action of Suecinylcholine

• Moon BK
• Shin YS
• Park KW
• Cho CH

• KMID: 1933264
• DOI: http://doi.org/10.4097/kjae.1987.20.5.637

Abstract

The interaction between succinylcholine (SCC) and anticholinegterase drugs is illustrated by the inhibition of acetylcholine hydrolysis or a decrease in pseudocholinesterase activity- The present study was performed in order to estimate the action duration of SCC and pseu- docholinesterase activity following the administeration of neostigmine or pyridostigmine. Thirty-two healthy adult patients under general inhalation anesthesia with either halothane or enflurane were given two 1 mg/kg doses of SCC intravenously. The first dose was givenimmediatelr before intubation while the tole second dose was administered when recovery to the single twitch response was at 75% following a 0.035 mg/kg dose of neostigmine (group l) or a 0.175 mg/kg dose of pyridostigmine (group ll). Delete this phase or explain it better , Electromrographic monitoring(with Relaxograph, ABM , Datex) was employed for the duration of the SCC-induced block. Pseudocholinesterase activity was measured immediately before the first dose of SCC, at the 75% twitch recovery after reversal, and at the 75% twitch recovery after the second dome of SCC. The duration of the second dose or SCC in groups l and ll, 31.62+/-5.91 and 29.94+/-6.91 min.. repectively, was significantly prolonged from that of the first dose(groups l and ll , 18.38+/-8.85 and 18.24+/-6.47 min., respectively, but there was no significant difference between the two groues, Train-of-four ratio following the second dose of SCC was found to be 74.44+/-19.12 and 51. 73+/-18.80 per cent in groups l and ll, respectively, and there was no difference between the two groups. The recovery of 75% single twitch from the second dose of SCC was observed, while pseudocholinesterase activity remained suppressed at 50.8 and 44.3 per cent in groups l and ll, respectively. It is suggested that the SCC-induced block following administration of anticholinesterase drugs such as neostigmine or pyridostigmine may be prolonged due to decreased pseudocho-linesterase activity and that the mode of action may be transformed to a phase ll block.

MeSH Terms

Acetylcholine
Adult
Anesthesia, Inhalation
Cholinesterase Inhibitors*
Enflurane
Halothane
Humans
Hydrolysis
Intubation
Neostigmine
Neuromuscular Blockade*
Pseudocholinesterase
Pyridostigmine Bromide
Succinylcholine
Acetylcholine
Cholinesterase Inhibitors
Enflurane
Halothane
Neostigmine
Pseudocholinesterase
Pyridostigmine Bromide
Succinylcholine