Neuromuscular Blocking Activity of Tubocurarine in Patients With Diabetes Mellitus †

Abstract

Previous clinical reports have suggested that deep tendon reflexes of diabetic patients are delayed and experimental studies have reported differential sensitivity of motor endplates to neuromuscular blocking drugs. These observations prompted us to study the neuromuscular effect of tubocurarine in 25 diabetic and 15 non-diabetic patients during urological surgery. Anaesthesia was induced with thiopentone followed by suxamethonium and maintained with nitrous oxide in oxygen and increments of butorphanol. Muscle relaxation was provided with tubocurarine in an initial dose of 0.25 mg kg-1 and increments of 20% of the initial dose. At the end of surgery, residual neuromuscular block was antagonized with increments of neostigmine 0.5 mg and atropine 0.2 mg. There was a delay in the onset of action of tubocurarine in diabetic patients. A no-response state was obtained in some patients, and its duration correlated with post-tetanic count (PTC) in diabetic patients, and with post-tetanic twitch height percent (PTTH%) in the control group. We concluded that, in diabetic patients, the onset of action of tubocurarine was delayed compared with control patients, and the reliable predictor of the duration of the no-response time was PTC in diabetic patients and PTTH% in non-diabetic subjects.

Residual neuromuscular block in type II diabetes mellitus after rocuronium

“…This finding was also made in the studies by Saitoh, Alper and Atallah and colleagues. [4][5][6][7]22 Sustained hyperglycaemia may be involved in the pathogenesis of subclinical neuropathy, leading to prolongation of the effect of neuromuscular blockers. Earlier studies in diabetic patients did not seek a relationship between glycaemic control and characteristics of the neuromuscular block, probably because of the small numbers in the diabetic groups.…”

Diabetes Mellitus and Neuromuscular Blockade: Review

“…In 1992, Atallah [12] was the first researcher who studied the effect of NMBA in patients with DM. He administered repeated doses of 0.25 mg/kg of tubocurarine.…”

Electrochemistry of the Arrow Poison, Tubocurarine, Using Boron Doped Diamond Electrode: Experimental and Theoretical Approaches

“…For this reason, knowledge of the electrochemical behavior and quantitative analysis of TUB, as well as DNA binding interaction and interactions with metal ions, should be beneficial for further research including this chemical compound. 5,6 Electrochemical methods are representing fast, reliable, sensitive, and selective procedures for detection of biological and organic compounds as well as metallic ions. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] These methods can involve either chemically modified electrodes or unmodified solid electrodes.…”