Electrolyte imbalance, particularly potassium depletion, has frequently been incriminated as an important factor in the etiology of 'neostigmine resistant curarisation' after the administration of nondepolarising muscle relaxants 1 ,~ 374. On the other hand, prolonged apnoea following the use of depolarising agents such as suxamethonium has seldom been ascribed to this cause5.6.7~ 8. In fact it has been recommended that suxamethonium be used in preference to nondepolarising agents in patients suffering from intestinal obstruction, where electrolyte disturbances are likely to be presentg. It has been the author's practice to use suxamethonium as the relaxant in these cases; formerly as a continuous drip infusion, but recently in combination with tetrahydroaniinacrine, a method which is more convenient and has fewer disadvantages 1 07 1 1, This case is presented, however, because it would seem to show that depolarising agents are not entirely innocuous under such circumstances.
C A S E R E P O R TThe patient was an African male aged 35 years who was admitted to hospital on 19 March 1965. A history was difficult to obtain as he was somewhat confused, but it was discovered that he had been suffering from diarrhoea with blood and mucus in his stools for about one month. Twenty four hours before admission severe abdominal pain and vomiting had occurred, his abdomen had become distended and his bowel actions had ceased.On examination he was found to be emaciated and dehydrated. The pulse rate was 110 per minute, blood pressure 110/70mmjHg and temperature 98.2"F. The abdomen was distended and tense and no
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