Potentiation of neuromuscular blockade by calcium channel blockers.
A significant reduction was noticed in the amount of vecuronium needed to maintain steady neuromuscular blockade at 20% twitch height (T1) in patients given nicardipine intraoperatively. Bolus injection of either nicardipine or diltiazem during constant infusion of vecuronium produced transient depression of T1 and the train-of-four ratio (TOFR). Reversal of neuromuscular blockade with a choline esterase inhibitor (neo-stigmine) was not retarded by previous administration of Ca-channel blockers but concurrent administration of anticholine-esterase agent and Ca-channel blockers caused a delay in recovery from motor blockade. Monitoring of neuromuscular junction activity is strongly recommended whenever a large cumulative dose of Ca-channel blockers is used.
Takiguchi
M
M
Department of Anesthesiology, Tokai University School of Medicine, Kanagawa, Japan.
Takaya
T
T
D000328:Adult; D000368:Aged; D002118:Calcium / Q000494:pharmacology; D004357:Drug Synergism; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation / Q000187:drug effects; D009469:Neuromuscular Junction / Q000187:drug effects* / Q000502:physiology; D009529:Nicardipine / Q000008:administration & dosage / Q000494:pharmacology*; D014673:Vecuronium Bromide / Q000008:administration & dosage
D014673:Vecuronium Bromide; D009529:Nicardipine; D002118:Calcium