Comparison of the Respiratory Effects of Suxamethonium and Suxethonium in Man

The Influence of Glucocorticoids on Plasma Cholinesterase

“…It is the enzyme that hydrolyzes the widely used neuromuscular blocking agent, succinylcholine chloride (10,11) and the ester-type local anesthetics, for example, procaine hydrochloride or tetracaine hydrochloride ( 13, 14). Significant decrease of BuChE activity may increase the intensity and duration of action of hydrolyzable muscle relaxants (15)(16)(17) and the systemic toxicity of ester-type local anesthetic agents (18).…”

The Fate of Muscle Relaxants in Man

“…Decreased enzymatic hydrolysis of succinylcholine in plasma, without other complicating factors, is not likely to cause extreme prolongation of neuromuscular activity. This is evident from the finding that no alarmingly prolonged apneas developed after 0.6 mg/kg doses of succinylcholine to patients in terminal stages of liver disease (F. F. FOLDES et al (1956b) 16), in whom plasma cholinesterase activity was markedly decreased (see Table 3). The situation may be different if large doses of succinylcholine are administered to patients with decreased plasma cholinesterase activity and diminished urinary excretion.…”

The pharmacology of neuromuscular blocking agents in man

“…These difficulties can be partly eliminated by (a) using the same anesthetic agents and methods in the investigation .of all relaxants; (b) determining control values after stabilization of the level of anesthesia; and (c) measuring the effect of the relaxant on tidal volume in the absence of surgical stimuli. 146 The effect of neuromuscular blocking agents on the tidal volume of anesthetized subjects is summarized in Table IV. The relative sparing effect of nondepolarizing relaxants on respiration is again evident.…”

“…In agreement with this, the plasma eholinesterase level deereases in proportion to the severity of the liver involvement. 146 Red eell eholinesterase aetivity, however, remains at normal levels even in the terminal stages of liver disease. The disposition of SCh in the human organism depends primarily .on its hydrolysis by plasma eholinesterase.…”

“…N euromuseular bloek of exeessively long duration (prolonged apnea), however, was not eneountered in any of these patients, some of whom were in the terminal stages of liver cirrhosis. 146 Detoxifieation of d-Te and dim-Te oeeurs, at least in part, in the liver .of mammals. 313 ,386 Despite this, Dundee and Gray99 reported that patients with liver damage exhibited deereased sensitivity to d-Te and suggested that the deereased plasma eholinesterase aetivity may be responsible.…”