Residual Post-Operative Paralysis

Abstract

For several hours after anesthesia in which a nondepolarizing muscle relaxant has been used, many patients show ptosis and nystagmus which suggest a minor degree of paralysis. Particularly striking is the associated finding of a divergent position of the eyes and the extent of this divergence can be used as a very sensitive measure of the effects of small amounts of muscle relaxant. The results are presented here of the application of such measurements in the investigation of the incidence and nature of residual paralysis in the post-operative period.Methods

Factors Limiting the Rate of Termination of the Neuromuscular Blocking Action of Fazadinium Dibromide

“…For example, in patients with renal insufficiency the paralysing actions of gallamine (Feldman & Levi, 1963;ChurchillDavidson, 1967), tubocurarine (Logan, Howie & Crawford, 1974) and pancuronium (Somogyi, Shanks & Triggs, 1977) are prolonged because elimination via the kidneys is a major determinant for the termination of the paralysing actions of these drugs and succinylcholine causes a prolonged apnoea in patients deficient in serum pseudocholinesterase. A further example is the recurarisation which occurs occasionally after apparently complete reversal of competitive neuromuscular block or by an anticholinesterase agent (Foldes, 1960;Hannington-Kiff, 1970). Recurarisation is probably a consequence of effective plasma concentrations of these drugs being sustained after the effect of the anticholinesterase agent has waned.…”