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British Journal of Anaesthesia, Vol 79, Issue 3 379-381, Copyright © 1997 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATIONS

Twitch augmentation and train-of-four fade during onset of neuromuscular block after subclinical doses of suxamethonium

S. Y. Kim, J. S. Lee, S. C. Kim and W. Park
Department of Anaesthesiology, School of Medicine, Soon Chun Hyang University and Hospital, 58-657 Hannam-Dong, Yongsan-Ku, Seoul 140-210, Korea

We have studied the train-of-four (TOF) response mechanomyographically during onset of neuromuscular block produced by subclinical doses of suxamethonium in order to follow the augmentation of the first twitch of the TOF (T1) and TOF fade compared with control TOF responses before the drug was given. In the groups given suxamethonium 0.05, 0.1, 0.2 and 0.3 mg kg-1, the increments in T1 after administration of the drug were observed before twitch depression occurred; these were mean 22.3 (SEM 8.1)%, 19.2 (3.3)%, 10.8 (2.0)% and 4.2 (2.2)%, respectively. This effect was more marked with the lower doses (P < 0.05). The degree of TOF fade was moderate during onset of neuromuscular block and depended on the dose of drug. The results of this study suggest that low doses of suxamethonium produced transient increase in muscle tension and twitch depression with significant TOF fade. We conclude that suxamethonium was associated with presynaptic effects as a consequence of brief stimulation of acetylcholine release followed by progressive diminution at the neuromuscular junction.
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