Conclusion
These studies on the disadvantages of succinyldicholine are not intended to detract from what is a most useful clinical relaxant. Nevertheless, they indicate the urgent necessity to find a short-acting non-depolarizing drug., At the meeting in Venice on muscle relaxants in 1958, just such a compound (namely “Compound 41”) was described, which appealed from animal experiments to be highly promising.4 Alas! the investigations in main showed that it produced] profound histamine release with severe hypotension and tachycardia, and was quite unsuitable for clinical use. Haining5,6 has stimulated our interest in a series of tropine derivatives. By a careful pharmacological analysis he has produced several most interesting compounds. Some have had a shorter action than succinyldicholine, while others have proved much longer-acting. All have been found to act like d-tubocurarine.
One compound, “DF 752” is of particular interest (Fig. 7).
Unfortunately, this is not the very short-acting drug we were seeking. Nevertheless, in a limited clinical trial it has shown certain advantages over gallamine triethiodide. It has a shorter duration of action (10—15 min.) and the degree of tachycardia is lower. Paralysis of the laryngeal muscles is rapidly achieved.
Résumé
Il existe une gamme étendue de relaxants musculaires à action dépolarisante utilisables en clinique, mais le succinyldicholine est le seul qui jouisse ďune popularité qui ne s’est jamais démentie. Toutefois cette substance présente deux inconvénients principaux. D’une part, elle entraîne des douleurs musculaires au cours de la période post-opératoire; diverses tentatives pour réduire la fréquence de cette complication sont discutées. D’autre part, toutes les substances à action dépolarisante sont susceptibles de modifier progressivement le blocage sousjacent jusqu’ à ce qu’apparaisse un blocage du type non dépolarisant. En bref, on se trouve en présence d’un double blocage. Ľauteur expose ľincidence et les conditions nécessaires à ľapparition de ce dernier type de blocage (blocage double).
Aussi, le désir de surmonter les principaux inconvénients du succinyldicholine a-t-il conduit à rechercher intensivement un type de relaxant musculaire à action brève et non dépolarisante. Les résultats de ces recherches sont exposés.
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Based on a paper read at the Second World Congress of Anaesthesiologists, Toronto, Canada, Sept., 1960.
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Churchill-Davidson, H.C. The changing pattern of neuromuscular block. Can. Anaes. Soc. J. 8, 91–98 (1961). https://doi.org/10.1007/BF03021338
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DOI: https://doi.org/10.1007/BF03021338