Efeito da associação ropivacaina‐pancurônio na transmissão neuromuscular e eficácia da neostigmine e 4‐aminopiridina na reversão do bloqueio: estudo experimental

Abstract

Ropivacaine increased the neuromuscular block produced by pancuronium. The complete antagonism with 4-aminopyridine suggests presynaptic action of ropivacaine.

Effect of 50% enantiomeric excess bupivacaine mixture combined with pancuronium on neuromuscular transmission in rat phrenic nerve-diaphragm preparation; a pilot study

“…Similarly to other studies,[ 3 ] we observed that a 50% enantiomeric excess bupivacaine mixture in the concentration used did not alter MPs of muscle fibres. Muscle MP was maintained within normal limits.…”

“…The influence of local anaesthetics on these parameters may indicate a presynaptic action, consequently decreasing acetylcholine release or reducing the sensitivity of the postjunctional membrane to acetylcholine. [ 1 3 9 10 11 12 13 ] In our study, impaired neurotransmitter release was observed. This event was demonstrated by a progressive decrease in the frequency and amplitude of MEPPs.…”

“…However, local anaesthetics may potentiate neuromuscular block produced by different neuromuscular blocking drugs. [ 1 2 3 13 23 ]…”

“…However, clinical and experimental evidences suggest that these drugs may interfere with the neuromuscular transmission and potentiate the effects of neuromuscular blocking drugs. [ 1 2 3 ] It is highly important to understand that neuromuscular blockers may interact with other drugs used simultaneously during anaesthesia. These drugs can alter the margin of safety of neuromuscular transmission and modify the effects of neuromuscular blocking drugs.…”