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Anesthesia Progress 2016
Topics: Androstanols; Anesthetics; Humans; Rocuronium; Succinylcholine; Sugammadex; gamma-Cyclodextrins
PubMed: 27973937
DOI: 10.2344/0003-3006-63.4.173 -
Anaesthesia Jun 2002
Topics: Drug Hypersensitivity; Female; Humans; Neuromuscular Depolarizing Agents; Patient Identification Systems; Succinylcholine; Tattooing
PubMed: 12071179
DOI: 10.1046/j.1365-2044.2002.265830.x -
Anesthesiology Oct 2001
Topics: Child; Humans; Injections, Intramuscular; Laryngismus; Neuromuscular Depolarizing Agents; Succinylcholine
PubMed: 11605908
DOI: 10.1097/00000542-200110000-00044 -
British Journal of Anaesthesia Jul 1999Neuromuscular blocking agents are used commonly in paediatric anaesthesia, both to facilitate tracheal intubation and during surgery. Paediatric patients differ from... (Review)
Review
Neuromuscular blocking agents are used commonly in paediatric anaesthesia, both to facilitate tracheal intubation and during surgery. Paediatric patients differ from adults in certain pharmacokinetic and pharmacodynamic characteristics. However, because maturational changes in certain of these characteristics counterbalance, dosing requirements do not differ markedly with age. In general, onset is more rapid in paediatric patients than in adults. Succinylcholine is still used commonly in children, despite restrictions by regulatory authorities, because of its rapid onset and offset. However, newer non-depolarizing neuromuscular blocking agents, particularly mivacurium, rocuronium and rapacuronium, offer many of the advantages of succinylcholine without its severe adverse effects: rocuronium and rapacuronium have an onset comparable with that of succinylcholine whereas the onset of mivacurium is slightly longer. In addition, recovery from an intubating dose of either mivacurium or rapacuronium is nearly comparable with that of succinylcholine. If rapacuronium i.m. proves to have a rapid onset without prolonged duration, the remaining value of succinylcholine will diminish.
Topics: Adult; Child; Humans; Neuromuscular Blockade; Neuromuscular Blocking Agents; Neuromuscular Depolarizing Agents; Neuromuscular Nondepolarizing Agents; Succinylcholine
PubMed: 10616334
DOI: 10.1093/bja/83.1.58 -
Anesthesiology Apr 2006Succinylcholine is one of the most widely used muscle relaxants in clinical anesthesia and emergency medicine. Although the clinical advantages and cardiovascular side...
BACKGROUND
Succinylcholine is one of the most widely used muscle relaxants in clinical anesthesia and emergency medicine. Although the clinical advantages and cardiovascular side effects are well known, its mechanism of action within the human nicotinic cholinergic receptor system remains to be understood. The aim of this study was to investigate the effect of succinylcholine on human muscle and neuronal nicotinic acetylcholine receptor (nAChR) subtypes.
METHODS
Xenopus laevis oocytes were injected with human messenger RNA for muscle and neuronal nAChR subunits. Receptor activation, desensitization, and inhibition induced by the natural ligand acetylcholine or by succinylcholine was studied using a multichannel two-electrode voltage clamp setup. Responses were measured as peak current and net charge.
RESULTS
Succinylcholine concentration-dependently activated the muscle-type nAChR with an EC50 value of 10.8 microm (95% confidence interval, 9.8-11.9 microm), and after the initial activation, succinylcholine desensitized the muscle-type nAChR. Succinylcholine did not activate the neuronal nAChR subtypes alpha3beta2, alpha3beta4, alpha4beta2, or alpha7 at concentrations up to 1 mm and was a poor inhibitor at these receptor subtypes, with IC50 values above 100 microm.
CONCLUSION
Succinylcholine activates the muscle-type nAChR followed by desensitization. The observation that succinylcholine does not inhibit the presynaptic alpha3beta2 autoreceptor at clinically relevant concentrations provides a possible mechanistic explanation for the typical lack of tetanic fade in succinylcholine-induced neuromuscular blockade. Finally, cardiovascular side effects (e.g., tachyarrhythmias) of succinylcholine are not mediated via direct activation of the autonomic ganglionic alpha3beta4 subtype because succinylcholine does not activate the neuronal nAChRs.
Topics: Acetylcholine; Animals; Dose-Response Relationship, Drug; Humans; Muscles; Neuromuscular Depolarizing Agents; Neurons; Protein Subunits; Receptors, Nicotinic; Succinylcholine; Xenopus laevis
PubMed: 16571968
DOI: 10.1097/00000542-200604000-00017 -
Tidsskrift For Den Norske Laegeforening... Feb 2010Muscle relaxants were introduced into clinical anaesthesia for the first time in 1942. The purpose of this article is to provide an overview of the history of muscle... (Review)
Review
BACKGROUND
Muscle relaxants were introduced into clinical anaesthesia for the first time in 1942. The purpose of this article is to provide an overview of the history of muscle relaxants, their mode of action and their role in current anaesthetic practice.
MATERIAL AND METHOD
The review is based on clinical experience, own research and a non-systematic literature search using PubMed.
RESULTS
A muscle relaxant is either suxamethonium (curacit) or one of many curare compounds. One of the curare drugs was brought to Europe from South America in the 1700 s and the active substance (called d-tubocurarine) was isolated in 1935. This type of drug paralyses striated muscles that are under voluntary control by interfering with the normal signalling system between nerve and muscle. Muscle relaxants provide optimal relaxation of skeletal muscles during surgical procedures, an effect that otherwise may require the use of high doses of anaesthetic drugs. However, muscle relaxants are not anaesthetic drugs, do not affect consciousness and have no pain relieving effect. A muscle relaxant that works optimally in all clinical settings has unfortunately not been developed so far.
INTERPRETATION
Muscle relaxants are generally safe drugs when used appropriately, but especially suxamethonium may have serious side effects. A muscle relaxant is regularly used during induction of anaesthesia, but less during surgery, because modern anaesthetics possess some muscle relaxing effect.
Topics: History, 20th Century; Humans; Motor Endplate; Neuromuscular Nondepolarizing Agents; Preanesthetic Medication; Receptors, Cholinergic; Succinylcholine; Tubocurarine
PubMed: 20220868
DOI: 10.4045/tidsskr.08.0323 -
BMC Anesthesiology Mar 2014While the impact of volatile anaesthetics to induce malignant hyperthermia (MH) is abundantly clear, the role of succinylcholine still remains controversial. To evaluate...
BACKGROUND
While the impact of volatile anaesthetics to induce malignant hyperthermia (MH) is abundantly clear, the role of succinylcholine still remains controversial. To evaluate the influence of succinylcholine on porcine MH events, the authors investigated the hemodynamic and metabolic responses in MH susceptible (MHS) and non-susceptible (MHN) swine following either succinylcholine or halothane application alone or a combination of both substances.
METHODS
With approval of the local animal care committee 27 MHS and 30 MHN pigs were anaesthetized and mechanically ventilated. Fiberoptic probes for continuous PCO2 measurement were inserted into the femoral vein and the triceps muscle. Group A received succinylcholine 4 mg/kg, group B incremental doses of halothane (0.5, 1.0 vol%) and group C succinylcholine and halothane simultaneously. Vital signs were recorded continuously.
RESULTS
Prior to drug application measured values did not differ between MHS and MHN. While MHN pigs did not show relevant alterations, succinylcholine, halothane and the combination of both lead to significant hemodynamic and metabolic changes in MHS swine.
CONCLUSIONS
Hemodynamic and metabolic alterations following succinylcholine were similar to halothane in MHS pigs. The combination of both pharmacological agents potentiated the observed effects. According to these results succinylcholine acted as an independent and supportive factor during onset of an MH episode.
Topics: Animals; Blood Gas Analysis; Blood Gas Monitoring, Transcutaneous; Halothane; Hemodynamics; Malignant Hyperthermia; Succinylcholine; Swine
PubMed: 24606822
DOI: 10.1186/1471-2253-14-14 -
Orphanet Journal of Rare Diseases Jul 2022Malignant hyperthermia (MH) is a rare, hereditary disease with a hypermetabolic response to volatile anesthetics/succinylcholine. Susceptible patients face difficulties...
BACKGROUND
Malignant hyperthermia (MH) is a rare, hereditary disease with a hypermetabolic response to volatile anesthetics/succinylcholine. Susceptible patients face difficulties due to a lack of knowledge about MH. As informational materials could increase knowledge and adherence to prevention/therapy, digital information about rare diseases validated for patients is needed. Our objective was to evaluate the following: (1) the impact of digital manuals on the knowledge/quality of life of MH patients and (2) access to MH services.
MATERIALS AND METHODS
Fifty MH-susceptible patients filled out a virtual questionnaire twice (demographic/economic/clinical data, MH knowledge and impact on daily life, and SF-36 quality of life). Test groups 1 (n = 17) and 2 (n = 16) were evaluated 30 and 180 days after receiving a digital manual, and the control group (n = 17; without manual) was evaluated after 180 days. We collected the MH service data about the number of contacts.
RESULTS
Twenty-four (48%) patients reported problems in personal/professional life, sports, clinical/surgical/dental treatments, and military service, in addition to concerns about emergency care and complaints of sequelae. The percentage of correct answers in the second MH knowledge questionnaire increased for test group 2 (62% vs. 74.1%; unpaired t test, p < 0.01), was significantly greater in test groups 1 (68.1%) and 2 (74.1%) than in the control group (56.5%; Kruskal-Wallis, p < 0.05), and correlated with more time studying the manual and reports of MH-related problems (multiple regression, p < 0.05).
CONCLUSIONS
The digital manual improved patients' MH knowledge. Online contacts with the MH service increased, allowing greater information dissemination. As informational materials could increase knowledge/adherence to prevention/therapy, digital information about MH validated for patients should be implemented.
Topics: Humans; Malignant Hyperthermia; Patient Education as Topic; Quality of Life; Succinylcholine
PubMed: 35841058
DOI: 10.1186/s13023-022-02435-1 -
British Journal of Anaesthesia Sep 1980
Topics: Anesthesiology; Humans; Infant, Newborn; Neuromuscular Junction; Pancuronium; Succinylcholine; Synaptic Transmission; Tubocurarine
PubMed: 6254549
DOI: 10.1093/bja/52.9.962-a -
Anesthesiology Mar 1979
Topics: Apnea; Butyrylcholinesterase; Humans; Succinylcholine
PubMed: 434523
DOI: 10.1097/00000542-197903000-00028