Neuromuscular effects of succinylcholine on the vocal cords and adductor pollicis muscles.

Abstract:

:To quantify the effects of succinylcholine at the laryngeal adductor muscles and the adductor pollicis, 17 adult patients were studied during propofol-fentanyl anesthesia. Train-of-four stimulation was applied to the ulnar nerve at the wrist and the recurrent laryngeal nerve at the notch of the thyroid cartilage. Laryngeal response was measured as pressure changes in the cuff of the tracheal tube positioned between the vocal cords. The force of contraction of the laryngeal adductor muscles and of the adductor pollicis were compared after administration of 0.25 or 0.5 mg/kg of succinylcholine. With 0.25 mg/kg, maximum blockade of first twitch (T1) was 66% +/- 10% (mean +/- SEM) and 45% +/- 13% at the vocal cords and the adductor pollicis, respectively (P less than 0.01). After 0.5 mg/kg, maximum blockade at the vocal cords (93% +/- 2%) and the adductor pollicis (84% +/- 6%) did not differ significantly. For both doses, time to maximal blockade was shorter for the vocal cords (0.9 +/- 0.1 min) than for the adductor pollicis (1.7 +/- 0.2 min; P less than 0.01). Time to 90% recovery of T1 after a bolus of 0.5 mg/kg was similar at the vocal cords (4.3 +/- 0.5 min) and the adductor pollicis (5.2 +/- 0.8 min) (NS). The ED50 was less at the laryngeal adductors (0.170 mg/kg) than at the adductor pollicis (0.278 mg/kg). It is concluded that, in adults, succinylcholine-induced blockade is more rapid and more intense at the laryngeal muscles than at the adductor pollicis.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Meistelman C,Plaud B,Donati F

doi

10.1213/00000539-199109000-00009

subject

Has Abstract

pub_date

1991-09-01 00:00:00

pages

278-82

issue

3

eissn

0003-2999

issn

1526-7598

journal_volume

73

pub_type

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