The Pharmacokinetic Response of Succinylcholine from Blood Flow occlusion

Yoon, Suk Jun; Kim, Chun Sook; Cha, Young Deog; Kim, Yong Ik; Kang, Kyu Sik; Kim, Sung Yell

Abstract

There is a direct relationship between the plasma concentration of the drugs and the magnitude of neuromuscular blockade in non-depolarizing neuromuscular blocking agents. But the classical pharmacokinetic data of succinylcholine have not been obtained because of the lack of an appropriate assay to detect plasma concentration hydrolyzed rapidly by pseudocholinesterase. The purposes of this study was to determine neuromuscular response from the release of minute interval of toumiquet occlusion after intravenous bolus adminstration of succinylcholine at one arm following blood flow occlusion at contralateral arm with pneumatic toumiquet. The twitch height of neuromuscular responses after adminisration of succinylcholine was completely depressed in the group(control) without occlusion, but 5.40+/-3.63% on 1 minute, 30.11+/-9.72% on 2 minutes, 85.00+/-4.19% on 4 minutes and 97.75+/-0.59% on 5 minutes after blood flow occlusion respectively. The onset time of maximum depression in each group was not significant different. At 5 minutes after succinylcholine given systemically, the twitch height was 8.35%, while it was 97.75% from tourniquet release on 5 minutes after blood flow occlusion. It is concluded that succinylcholine should be also related to plasma concentration in magnitude of neuromuscular block, and receptor binding(dissociation constant) more than plasma concentration in offset of neuromuscular blockade.