Abstract
The effects of succinylcholine (1.5mg·kg-1 IV) administered five minutes after a defasciculating dose of curare (0.05 mg·kg-1 IV), were compared with the effects ofatracurium (0.5 mg·kg-1 IV) on intracranial pressure (ICP) in 13 cynomologus monkeys with intracranial hypertension (ICP· 25 mmHg). Neither succinylcholine nor atracurium increased ICP during general anaesthesia with 60 per cent N2O/O2, 0.5-1 per cent halothane. During a rapid sequence induction and intubation with thiopentone 5 mg·kg-1 IV, ICP increased equally with intubation following both atracurium (25 ± 1 to 32 ± 2 mmHg) and succinylcholine (25 ± 1 to 31 ± 2 mmHg) (p < 0.05). Intubation was also associated with significant increases in PaCO2, CVP and MAP. We conclude that in this primate model of intracranial hypertension, neither atracurium nor succinylcholine (when given following a defasciculating dose of curare) elevates ICP. In terms of the elevation of ICP associated with intubation, atracurium was found to offer no advantage over succinylcholine.
Résumé
Les effets de I’administration de succinylcholine (1.5 mg· kg-1) cinq minutes après une dose qui empêche la fasciculation de curare (0.05 mg·kg-1 IV) ont été comparés avec les effets de l’atracurium (0.5 mg·kg-1 IV) sur la pression intracrdnienne (ICP) chez 13 singes cynomologus avec hypertension intracrdnienne (ICP · 25 mmHg). Ni la succinylcholine ni l’atracurium ont augmenté la pression intracrânienne lors de l’anesthesie générate avec 60 pour cent de protoxyde d’azote/ oxygène, et 0.5-1 pour cent d’halothane. Lors de l’induction à séquence rapide et l’intubation avec le thiopentone 5 mg·kg-1 IV, la pression intracrânienne a augmenté également avec l’intubation suite à l’atra-curium (25 ± 1 à 32 ± 2 mmHg) et le succinylcholine (25 ± l à 31 ± 2 mmtig) (p < 0.05). L’intubation a aussi été associée avec une augmentation significative de la PaC02, la pression veineuse centrale et la pression artérielle moyenne. On conclut que pour un seul modèle de primate en hypertension intracrânienne, ni l’atra-curium ni la succinylcholine (lorsque donné après une dose de curare empêchant lafasciculation) n’augmentent la pression intracrânienne. Quant à l’augmentation de la pression intracrânienne lors de l’intubation, I’atracur-ium n’a pas qffert davantage sur la succinylcholine.
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Supported by a research starter grant from the Anesthesiology Research Foundation. Presented in part at the ASA meeting in New Orleans October 1984.
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Haigh, J.D., Nemoto, E.M., DeWolf, A.M. et al. Comparison of the effects of succinylcholine and atracurium on intracranial pressure in monkeys with intracranial hypertension. Can Anaesth Soc J 33, 421–426 (1986). https://doi.org/10.1007/BF03010965
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DOI: https://doi.org/10.1007/BF03010965