Interaction of Muscle Relaxants and Local Anesthetics at the Neuromuscular Junction

The influence of lidocaine and racemic bupivacaine on neuromuscular blockade produced by rocuronium: a study in rat phrenic nerve-diaphragm preparation

“…Besides the likeness to the receivers, this stereoisomerism is also factor that contributes to the cellular membranes fluidly 19 . The results of this study resemble each other to the experimental and clinical researches [2][3][7][8][9][11][12][16][17] that also demonstrated that local anesthetics employed separately for different routes, don't commit neuromuscular transmission, but they potentiate neuromuscular blockade produced for different neuromuscular blocking.…”

“…These discoveries are confirmed in experimental works that have as larger advantage, in relation to the clinical researches, the possibility to eliminate the great individual sensibility variability to neuromuscular blocking agents [16][17] . The results obtained in this work show that in rat phrenic nerve-diaphragm preparation, lidocaine and racemic bupivacaine in the employed concentrations, and, separately administered don't commit neuromuscular transmission, however, the blockade produced by rocuronium in preparations previously exposed to the different local anesthetics was significantly larger than observed in preparations not exposed to local anesthetics.…”

“…Matsuo et al 17 evaluated in rat phrenic nerve-diaphragm preparation, the action of d-tubocurarine association to different local anesthetics as procaine, lidocaine and etidocaine, and they observed, neuromuscular blocking agents dose-response curve deviation to the left, reflecting increase in the potency of these drugs.…”

Efeito da utilização de 2 mg.kg-1 de lidocaína endovenosa na latência de duas doses diferentes de rocurônio e na resposta hemodinâmica à intubação traqueal

“…neuromuscular blockers more indicated for rapid sequence intubation are succinylcholine and rocuronium due to their lower latency 26 . the interaction between local anesthetics and neuromuscular blockers is known and demonstrated in different models 19,23,24,39,40 . local anesthetics have a strong capability of inhibiting several subtypes of nicotinic receptors of acetylcholine, including muscular 22,[41][42][43] .…”

“…the interaction of local anesthetics with preand post-synaptic nicotinic receptors in the neuromuscular junction explains this phenomenon [22][23][24] .…”