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British Journal of Clinical Pharmacology logoLink to British Journal of Clinical Pharmacology
. 1975 Dec;2(6):487–494. doi: 10.1111/j.1365-2125.1975.tb00565.x

The skeletal muscle response to the repeated administration of suxamethonium and its interaction with edrophonium in anaesthetised man.

N Sugai, R Hughes, J P Payne
PMCID: PMC1402647  PMID: 1234012

Abstract

Tetanic and single twitch contractions of the adductor pollicis muscle in man were recorded during repeated injections of suxamethonium (0.2 mg/kg or 0.1 mg/kg) every 15 minutes. 2 Tachyphylaxis to suxamethonium developed rapidly in every patient studied when single twitch contractions were observed but tetanic contractions later showed an increasingly prolonged recovery with repeated injections. 3 Edrophonium administered at the point of 50% recovery of the tetanic contractions in patients given suxamethonium (0.2 mg/kg) repeatedly first potentiated the blockade but when the tachyphylaxis had developed fully on the single twitch, usually after the third or fourth injection, the blockade of the tetanic contractions was reversed. 4 These findings indicate that the tachyphylaxis and the change in the nature of the blockade produced by suxamethonium in man take place at the same time and might be part of the same phenomenon.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. CHURCHILL-DAVIDSON H. C., CHRISTIE T. H. The diagnosis of neuromuscular block in man. Br J Anaesth. 1959 Jul;31:290–301. doi: 10.1093/bja/31.7.290. [DOI] [PubMed] [Google Scholar]
  2. Crul J. F., Long G. J., Brunner E. A., Coolen J. M. The changing pattern of neuromuscular blockade caused by succinylcholine in man. Anesthesiology. 1966 Nov-Dec;27(6):729–735. doi: 10.1097/00000542-196611000-00003. [DOI] [PubMed] [Google Scholar]
  3. Freund F. G. Tachyphylaxis to decamethonium and reversibility of the block by anticholinesterase drugs. Anesthesiology. 1969 Jan;30(1):7–11. doi: 10.1097/00000542-196901000-00005. [DOI] [PubMed] [Google Scholar]
  4. Galindo A. Depolarizing neuromuscular block. J Pharmacol Exp Ther. 1971 Aug;178(2):339–349. [PubMed] [Google Scholar]
  5. Gissen A. J., Nastuk W. L. The mechanisms underlying neuromuscular block following prolonged exposure to depolarizing agents. Ann N Y Acad Sci. 1966 Jan 26;135(1):184–194. doi: 10.1111/j.1749-6632.1966.tb45472.x. [DOI] [PubMed] [Google Scholar]
  6. Helmstein K. Treatment of bladder carcinoma by a hydrostatic pressure technique. Report on 43 cases. Br J Urol. 1972 Aug;44(4):434–450. doi: 10.1111/j.1464-410x.1972.tb10103.x. [DOI] [PubMed] [Google Scholar]
  7. KATZ R. L., WOLF C. E., PAPPER E. M. THE NONDEPOLARIZING NEUROMUSCULAR BLOCKING ACTION OF SUCCINYLCHOLINE IN MAN. Anesthesiology. 1963 Nov-Dec;24:784–789. doi: 10.1097/00000542-196311000-00006. [DOI] [PubMed] [Google Scholar]
  8. Katz R. L., Ryan J. F. The neuromuscular effects of suxamethonium in man. Br J Anaesth. 1969 May;41(5):381–390. doi: 10.1093/bja/41.5.381. [DOI] [PubMed] [Google Scholar]
  9. MOHELSKY H. M., RUBEN H. Wirkungsänderungen von Succinylcholinjodid bel kontinuierlicher Anwendung. Wien Med Wochenschr. 1953 Jul 4;103(27):503–504. [PubMed] [Google Scholar]
  10. ORNDAHL G., STENBERG K. Nerv-muskel-transmissionen vid dystrofia myotonica, belyst med muskelrelaxantia. Nord Med. 1956 Nov 8;56(45):1619–1622. [PubMed] [Google Scholar]
  11. PAYNE J. P., HOLMDAHL M. H. The effect of repeated doses of suxamethonium in man. Br J Anaesth. 1959 Aug;31:341–347. doi: 10.1093/bja/31.8.341. [DOI] [PubMed] [Google Scholar]
  12. POULSEN H., HOUGS W. The effect of some curarizing drugs in unanaesthetized man. II. Succinylcholine iodide and its bis-monoethyl-substituted derivative in continuous intravenous infusion. Acta Anaesthesiol Scand. 1958;2(3):107–115. doi: 10.1111/j.1399-6576.1958.tb05256.x. [DOI] [PubMed] [Google Scholar]
  13. Riker W. F., Jr, Standaert F. G. The action of facilitatory drugs and acetylcholine on neuromuscular transmission. Ann N Y Acad Sci. 1966 Jan 26;135(1):163–176. doi: 10.1111/j.1749-6632.1966.tb45470.x. [DOI] [PubMed] [Google Scholar]
  14. Sugai N., Hughes R., Payne J. P. The effect of suxamethonium alone and its interaction with gallamine on the indirectly elicited tetanic and single twitch contractions of skeletal muscle in man during anaesthesia. Br J Clin Pharmacol. 1975 Oct;2(5):391–402. doi: 10.1111/j.1365-2125.1975.tb00547.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. THESLEFF S. A study of the interaction between neuromuscular blocking agents and acetylcholine at the mammalian motor endplate. Acta Anaesthesiol Scand. 1958;2(2):69–79. doi: 10.1111/j.1399-6576.1958.tb05252.x. [DOI] [PubMed] [Google Scholar]

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