The question as to whether halothane increases the neuro-muscular blocking action of pancuronium was answered affirmatively by Katz' on the basis of myographical findings published recently. This seems to be the only experimental evidence in man that halothane increases the effect of pancuronium and, if halothane is administered towards the end of an intra-abdominal operation in order to improve relaxation, it often fails to increase the action of pancuronium. This is in contrast to its striking effect when combined with other non-depolarizing agents.2 Stimulated by this observation, the interaction between halothane and pancuronium has been re-investigated m yographically.
Material and methodsTwenty-seven patients aged between 28 and 79 years undergoing various types of surgery were selected at random for the present study. Their physical condition was classified3 as risk I in four, risk I1 in thirteen, and risk I11 in nine cases. One patient was investigated twice 8 months apart.Atropine (ca. 0.0 1 mg/kg) combined with an analgesic was injected intramuscularly for premedication. The drugs were administered 20-60 minutes prior to anaesthesia, when pethidine (50-125 mg) was the analgesic, and 50-1 10 minutes before, respectively, when morphine (10-20 mg) was used. Anaesthesia was induced by rapid intravenous injection of 150-550 mg hexobarbitone (5% solution) followed by suxamethonium (@lo0 mg). After anaesthetising the glottis and trachea with 1% solution, intubation was performed. Anaesthesia was maintained with nitrous amethocaineoxide/oxygen (3 or 4.5/1.5 litres/minute), using a semiclosed circle absorption technique, occasionally supplemented by small intravenous doses of pethidine.In eight cases halothane was added from the beginning of inhalational anaesthesia; in one patient halothane was given concomitantly with the injection of pancuronium prior to surgery; in two further patients halothane was administered only during
By means of electromyographic investigation in man it could be demonstrated that halothane administered during recovery from neuromuscular block of pancuronium does not exert any measurable synergistic action to pancuronium. Halothane, therefore, may be combined freely with pancuronium in anaesthetic practice. In contrast to other non‐depolarising muscle relaxants there is no need to reduce the dose of either the relaxant or the anaesthetic (or both) when halothane and pancuronium are used together.ZUSAMMENFASSUNGMittels elektromyographischer Untersuchungen am Menschen konnte bewiesen werden, daß Halothan‐verabreichung wöhrend der Erholungsphase nach neuromuskulärer Blockade durch Pancuronium keinen meßbaren synergistischen Effekt zu Pancuronium hat. Halothan kann daher in der Anaesthesiepraxis uneingeschränkt mit Pancuronium kombiniert werden. Im Gegensatz zu anderen nichtdepolarisierenden Muskelrelaxantien muß weder die Dosis des Relaxans noch die des Anaesthetikums (oder beider) reduziert werden, wenn man Halothan und Pancuronium gemeinsam verwendet.
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