We have studied the onset, duration of action and recovery index of twice the ED90 of rocuronium (Org 9426) (0.6 mg kg-1) and of vecuronium (0.08 mg kg-1) in patients during enflurane anaesthesia. Rocuronium had a significantly shorter mean onset time of 1.8 (SD 0.4) min, compared with vecuronium 3.4 (0.8) min. Clinical duration (time for the first twitch in the train-of-four to recover to 25% of control) was similar for both drugs (29 (10) min vs 31 (12) min). Spontaneous recovery times (TOF ratio 70%) did not differ significantly between rocuronium (47 (10) min) and vecuronium (44 (11) min).
SUMMARYA report is given on a 76‐year‐old woman who suffered from apnoea for 9 hours after administration of 40 mg succinyldicholine chloride. Serological examinations showed normal protein fractions, normal acetylcholinesterase (specific ChE) activity and complete absence of SChE (non‐specific ChE) activity. Enzyme‐histochemical examinations of a liver‐biopsy specimen also failed to reveal any activity. ChE could not be detected with butyryl thiocholine or acetyl thiocholine as substrates, whereas non‐specific esterases reacted entirely normal. There was no correlation between liver function (especially albumin synthesis) and ChE activity in this case of anenzymia. The fatty infiltration of the liver is discussed as an effect of the ChE anenzymia. It became evident that even complete absence of SChE may occur without any symptoms of illness or any serious disturbances in the serum proteins. The use of depolarising relaxants and of certain other esters (as is known in the case of atypical ChE) may, however, lead to serious complications.ZUSAMMENFASSUNGEs wird über eine 76‐jährige Patientin berichtet, bei der nach 40 mg Succinylbischolinchlorid eine 9‐stündige Apnoe auftrat.Die serologischen Untersuchungen ergaben normale Eiweissfraktionen, eine normale Acetylcholinesterase‐ (spezifische ChE) und ein vollständiges Fehlen der Serumcholinesteraseaktivität (unspezifische ChE). Die enzymhistochemischen Untersuchungen nach Leberbiopsie liessen ebenfalls keinerlei Aktivität erkennen. Weder mit Butyryl‐ noch mit Acetylthiocholin als Substrat gelang ein Cholinesterasenachweis, wohingegen unspezifische Esterasen völlig normal reagierten. Das gleichsiimige Verhalten von Leberfunktion (besonders Albuminsynthese) und ChE‐Aktivität ist bei der Anenzymie nicht zu finden. Die festgestellte Leberverfettung wird als Folge der Anenzymie der ChE diskutiert.Es zeigte sich, dass auch bei völligem Fehlen der Serumcholinesterase keine manifesten Krankheitssymptome auftreten, dass aber (wie von der atypischen ChE bekannt) nach Anwendung depolarisierender Relaxantien und bestimmter anderer Ester lebensgefährliche Komplikationen auftreten können.
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