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British Journal of Anaesthesia, 1984, Vol. 56, No. 10 1131-1138
© 1984 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

IN VITRO INTERACTION OF DIAZEPAM AND OXAZEPAM WITH PANCURONIUM AND SUXAMETHONIUM

J. J. DRIESSEN, M.D., T. B. VREE, PH.D., J. VAN EGMOND, PH.D., L. H. D. J. BOOIJ, M.D., PH.D. and J. F. CRUL, M.D., PH.D.

Department of Anesthesiology, Catholic University of Nijmegen, Geert Groote Plein Zuid, 10, 6525 GH, Nijmegen, The Netherlands
Department of Anesthesiology, Free University of Amsterdam, Amsterdam, The Netherlands.

In vitro studies using the rat phrenic nerve-hemidiaphragm preparation were performed to investigate the effects of diazepam and three of its metabolites on indirectly evoked twitch tension. Diazepam, desmethyl-diazepam and temazepam alone caused an increase in twitch tension in lower concentrations, followed by complete depression in higher concentrations. Oxazepam did not cause an initial increase in twitch tension, but showed an immediate and dose-dependent depression. Cumulative concentration-response curves for pancuronium and suxamethonium in the presence of different concentrations of diazepam or oxazepam showed that small concentrations of diazepam, which did not change twitch tension alone, caused antagonism of the action of pancuronium, but not of suxamethonium. With ozazepam no such antagonism was observed. In liminal and supraliminal concentrations, both diazepam and oxazepam potentiated the action of pancuronium and suxamethonium. Possible implications for in vivo interactions are discussed.


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