Abstract
Succinylcholine 2–5 mg or atracurium 10–15 mg were given on five separate occasions to a 24-year-old, 64 kg woman homozygous for atypical plasma cholinesterase who was undergoing electroconvulsive therapy (ECT). Atracurium blockade was reversed with atropine, 0.6 mg and edrophonium, 35 mg. Train-of-four stimulation was applied to the ulnar nerve and the force of contraction of the adductor pollicis muscle was recorded. Doses producing 90 per cent first twitch blockade were 2.5 and 15 mg for succinylcholine and atracurium respectively. The onset of action was 6 min for both relaxants, and time to 90 per cent first twitch recovery was 20 min for succinylcholine and 16 min for the atracurium-edrophonium combination. It is concluded that the use of atracurium in these patients does not offer marked advantages over small doses of succinylcholine.
Résumé
On a administr’ de la succinylcholine 2–5 mg ou de ľatracurium 10–15 mg à cinq reprises chez une femme de 24 ans, pesant 64 kg. Cette malade était porteuse ďune cholinestérase plasmatique atypique et devait subir une sismothérapie. On a utilisé de ľédrophonium, 35 mg, avec de ľatropine, 0.6mg, pour antagoniser le bloc causé par ľatracurium. On a stimulé le nerf cubital et on a enregistré la force de contraction de ľadducteur du pouce en réponse au train-de-quatre. Les doses produisant un bloc de 90 pour cent était 2.5 mg de succinylcholine ou 15 mg ďatracurium. Le délai entre ľinjection et ľeffet maximum était de six minutes pour les deux curares. Pour observer une récupération de 90 pour cent, il a fallu attendre 20 minutes avec la succinylcholine et 16 minutes avec ľatracurium suivi ďédrophonium. En conclusion, ľutilisation de ľatracurium chez ces malades n’est pas nettement plus avantageuse que ľadministration de petites doses de succinylcholine.
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Hickey, D.R., O’Connor, J.P. & Donati, F. Clinical Reports. Can J Anaesth 34, 280–283 (1987). https://doi.org/10.1007/BF03015165
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DOI: https://doi.org/10.1007/BF03015165