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British Journal of Anaesthesia, 1987, Vol. 59, No. 6 784-790
© 1987 The Board of Management and Trustees of the British Journal of Anaesthesia

other

INTERACTION OF ADRENALINE WITH NEOSTIGMINE AND TUBOCURARINE AT THE SKELETAL NEUROMUSCULAR JUNCTION

P. J. DRURY, B.SC., PH.D., A. T. BIRMINGHAM, B.SC., M.B., B.S. and T. E. J. HEALY, M.SC., M.D., F.F.A.R.C.S.*,

Department of Surgery, Medical School, Queen's Medical Centre, University of Nottingham Nottingham
Department of Physiology and Pharmacology; Medical School, Queen's Medical Centre, University of Nottingham Nottingham
Department of Anaesthesia; Medical School, Queen's Medical Centre, University of Nottingham Nottingham

*Present address for correspondence: Department of Anaesthesia, University Hospital of South Manchester, Withington, Manchester M20 8LR.

The effects of neostigmine, and of neostigmine with adrenaline, on the response of the rat isolated hemidiaphragm to stimulation of the phrenic nerve are reported. Neostigmine augmented the response: a maximum augmentation occurred at a concentration of 6.4 x 10–7 mol litre–1. At greater concentrations of neostigmine the response was reduced. Adrenaline in the absence of neostigmine produced no significant change in the contraction response. However, in the presence of neostigmine further augmentation occurred and achieved a maximum in the presence of adrenaline 3.2 x 10–7–1.3x10–6 mol litre–1. Adrenaline 4.0 x 10–8–1.3x10–6 mol litre–1 combined with neostigmine 4.0x10–8–6.4 x10–7 mol litre–1 reversed tubocurarine-in-duced neuromuscular blockade more effectively than neostigmine alone(P < 0.001). Adrenaline appeared to enhance the antagonistic effect of neostigmine by increasing acetylcholine release and by enhancing the response at the post-junctional acetylcholine receptor.


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