Dual action of pancuronium on succinylcholine block.
The effects of pretreatment with both sub-paralyzing and paralyzing doses of pancuronium and d-tubocurarine, on the onset and duration of succinylcholine-induced neuromuscular blockade were evaluated and compared in 225 patients. D-tubocurarine antagonized both onset and duration of succinylcholine block, while pancuronium produced a dual effect, antagonizing the onset and potentiating the duration of succinylcholine block. Pretreatment with d-tubocurarine (0.07 mg/kg, 0.3 mg/kg and 0.6 mg/kg) increased the time to onset of succinylcholine paralysis from 28 to 118%, and decreased the duration from 16 to 37%. Pancuronium (0.02 mg/kg, 0.04 mg/kg and 0.08 mg/kg) also antagonized the onset of succinylcholine paralysis with increases of 32 to 114%, but potentiated its duration from 30 to 103% compared with succinylcholine alone in the same patients. Although pancuronium markedly inhibited serum cholinesterase in vitro (I50=5 X 10(-7) mol) there was only a 10% inhibition of cholinesterase in vivo after pancuronium 0.08 mg/kg.
D000328:Adult; D002802:Cholinesterases / Q000097:blood; D004347:Drug Interactions; D006801:Humans; D009407:Nerve Block; D010197:Pancuronium / Q000009:adverse effects; D013390:Succinylcholine; D013997:Time Factors; D014403:Tubocurarine / Q000009:adverse effects
D002802:Cholinesterases; D013390:Succinylcholine; D010197:Pancuronium; D014403:Tubocurarine