Abstract
Anticholinesterases were administered in an attempt to antagonize prolonged neuromuscular blockade following the administration of succinylcholine in a patient later found to be homozygous for atypical plasma cholinesterase. Edrophonium 10 mg, given 74 min after succinylcholine, when train-of-four stimulation was characteristic of phase II block, produced partial antagonism which was not sustained Repeated doses of edrophonium to 70 mg and neostigmine to 2,5 mg did not antagonize or augment the block. Spontaneous respiration recommenced 200 min after succinylcholine administration. It is concluded that anticholinesterases are only partially effective in restoring neuromuscular function in succinylcholine apnoea despite muscle twitch activity typical of phase II block.
Résumé
On a tenté, à l’aide d’anticholinestérasiques, de produire l’antagonisme d’un bloc neuromusculaire prolongé causé par l’administration de 12 mg.kg-1 de succinylcholine chez une patiente qui s’est avérée être homozygote pour la cholinestérase plasmatique atypique. On a donné 10 mg déédrophanium 74 minutes après l’administration de succinylcholine lorsque le train de quatre stimulations (train-of-four) possédait les caractéristiques d’un bloc de phase 11. Il en a résulté un antagonisme partiel et non soutenu. Le bloc neuromusculaire est demeuré inchangé à la suite de l’administration répétée d’édrophonium, jusqu’à une dose totale de 70 mg, et 2.5 mg de néostigmine. La patiente s’est mise à respirer spontanément 200 minutes après la dose de succinylcholine. On en conclut que les anticholinestérasiques ne sont que partiellement efficaces dans le traitement d’une apnée prolongée due à la succinylcholine et ce, en dépit des contractions stimulées caractéristiques d’un bloc de phase 11.
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Bevan, D.R., Donati, F. Succinylcholine apnoea: Attempted reversal with anticholinesterases. Can Anaesth Soc J 30, 536–539 (1983). https://doi.org/10.1007/BF03007091
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DOI: https://doi.org/10.1007/BF03007091