Abstract
Purpose
Muscles differ in their response to neuromuscular relaxants. This study investigated whether (1) the relative responses of muscles is inverted between succinylcholine (SUX) and vecuronium (VEC), and (2) differences in dose-response or duration of action are related to the morphology of fibres, endplates and acetylcholine receptors (AChR) in muscles.
Methods
In goats during thiopentone anaesthesia, the evoked EMC response to indirect train-of-four stimulation was monitored and the cumulative dose-response curves and duration of action of SUX and VEC in the diaphragm, cricoary-tenoideus dorsalis, thyroarytenoideus, transversus abdominis, rectus abdominis, soleus and gastrocnemius muscles were determined and related to their fibre composition, fibre size, endplate size, endplate to fibre size ratio, AChR number or AChR density by regression analysis.
Results
There were no differences in the ED50s of SUX [range, 119 ± 11 (SE) to 159 ± 20 μg · kg−1] or VEC [range, 2.8 ± 0.2 to 3.7 ± 0.8 μg · kg−1] among muscles. With either drug, duration to 25% or 50% T1 recovery was shortest at the laryngeal muscles and longest at abdominal muscles (P = 0.0001), and correlated directly with fibre size (r ≥ 0.40: P < 0.004) and inversely with the endplate to fibre size ratio (r ≥ 0.40; P < 0.008).
Conclusion
The results show that (I) the relative responses of muscles do not differ between depolarizing and non-depolarizing relaxants; (2) the duration of blockade is shorter in muscles composed of small fibres with large endplates relative to fibre size; and (3) there is no relation between fibre type composition and sensitivity to muscle relaxants.
Résumé
Objectif
Les muscles ne répondent pas tous de la même façon aux relaxants musculaires. Ce travail visait à étudier 1) si la réponse relative des muscles était inversée entre ta succinylcholine (SUX) et le vécuronium (VEC), et 2) les différences de la relation dose à effet et la durée d’action étaient en rapport avec la morphologie des fibres, des plaques motrices et des récepteurs acétylcholinergiques (AChR) des muscles.
Méthodes
Chez des chèvres anesthésiées au thiopentone, la réponse EMC évoquée à la stimulation du train-de-quatre a été monitorisée. Des courbes dose à effet, et la durée d’action de SUX et VEC au niveau du diaphragme, des muscles cricoaryténoïdiens, postérieurs, thyroaryténoïdien, Iransverses de l’abdomen, soléaires et gastrocnémiens ont été déterminées par analyse de régression en relation avec la composition des fibres, leur dimension, la rapport entre la dimension des plaque motrices et des fibres, le nombre et la densité d’AChR.
Résultats
L ’ED50 de SUX [étendue, 119 ± 11 (ET) à 159 ± 20 μg · kg−1] et de VEC [étendue, 2,8 ± 0,2 à 3,7 ± 0,8 μg · kg− 1] était la même pour tous les muscles. Avec chacun des deux relaxants, la durée de récupération de T1 de 25% ou 50% était plus courte au niveau des muscles laryngés et plus longue au niveau des muscles abdominaux (P = 0,0001) et était en corrélation directe avec la dimension des fibres (r ≥ 0,40, P < 0,008).
Conclusion
Ces résultats montrent que 1) la réponse relative des muscles est identique entre les relaxants dépolarisants et non dépolarisants; 2) la durée d’action est plus courte pour les muscles composés de petites fibres avec des grandes plaques motrices relativement à la dimension des fibres; et 3) il n ’existe pas de rapport entre le type de fibre et la sensibilité aux relaxants musculaires.
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C.I. held a Royal Victoria Hospital Research Institute Fellowship and an FRSQ Fellowship during this study. This work was presented in part at the 51st Canadian Anaesthetists’ Society Meeting, June 1994, Edmonton, Alberta, and at the XIIth International Congress of Pharmacology, July 1994, Montreal, Quebec.
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Ibebunjo, C., Srikant, C.B. & Donati, F. Duration of succinylcholine and vecuronium blockade but not potency correlates with the ratio of endplate size to fibre size in seven muscles in the goat. Can J Anesth 43, 485–494 (1996). https://doi.org/10.1007/BF03018111
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DOI: https://doi.org/10.1007/BF03018111