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Recurarisation following a suxamethonium–alcuronium sequence in patients with atypical cholinesterase
Author(s) -
BARAKA A.,
SIBAI A.N.,
HAMED M.,
DELLEH R.
Publication year - 1988
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1988.tb08982.x
Subject(s) - neostigmine , medicine , cholinesterase , anesthesia , tracheal intubation , rapid sequence induction , neuromuscular blockade , intubation , antagonism , muscle relaxation , sequence (biology) , block (permutation group theory) , pharmacology , receptor , geometry , mathematics , biology , genetics
Summary Alcuronium 10 mg was administered to maintain muscle relaxation in two patients before recovery from suxamethonium neuromuscular blockade to facilitate tracheal intubation. This sequence resulted in a markedly prolonged block which could not be antagonised adequately by neostigmine 0.05 mg/kg; initial antagonism was followed rapidly by prolonged recurarisation. Estimation of plasma cholinesterase activity revealed that the two patients were homozygous for the atypical and silent genes, respectively.