Potentiation of suxamethonium blockade by neostigmine in patients with atypical cholinesterase.
This report describes the potentiation of a suxamethonium-induced (0.1 mg/kg) neuromuscular block in two  children with atypical serum cholinesterase activity, and compares  it with a control response demonstrated in a homozygote brother. In the atypical homozygote patients, suxamethonium produced a markedly prolonged neuromuscular block associaiated with partial desensitizatin as evidenced by tetanic fade and post-tetanic facilitation. The use of neostigmine 0.05 mg/kg for reversal was followed by a paradoxical potentiation of the block and a marked delay in recovery. It is suggested that in atypical homozygotes, the development of desensitization after suxamethonium does not necessarily imply that the block will be reversed with neostigmine.
D000769:Anesthesia, Inhalation; D001285:Atropine / Q000494:pharmacology; D002648:Child; D002802:Cholinesterases / Q000172:deficiency*; D004357:Drug Synergism; D004558:Electric Stimulation; D006221:Halothane; D006720:Homozygote; D006801:Humans; D007275:Injections, Intravenous; D009119:Muscle Contraction / Q000187:drug effects; D009388:Neostigmine / Q000009:adverse effects* / Q000494:pharmacology; D009407:Nerve Block; D009609:Nitrous Oxide; D010100:Oxygen; D013390:Succinylcholine
D009388:Neostigmine; D001285:Atropine; D002802:Cholinesterases; D013390:Succinylcholine; D009609:Nitrous Oxide; D010100:Oxygen; D006221:Halothane