Cardiovascular Effects of Alcuronium in Man

The relative potency, time-course of action and cardiovascular effects of Org NC 45, a new non-depolarizing neuromuscular blocking agent, have been compared with those of pancuronium, alcuronium and tubocurarine in 64 anaesthetized patients. The relative potency (ED50) to Org NC 45 was 1.74, 3.69 and 8.57 respectively. In doses which caused useful surgical relaxation, duration of action of Org NC 45 was 34%, 39% and 26% that of pancuronium, alcuroniuym and tubocurarine. After administration of repeated doses no cumulation was seen for Org NC 45. The new drug was free from any effect on arterial pressure and heart rate.

Section: Discussionsupporting

confidence: 88%

Relative Potency of Org Nc 45, Pancuronium, Alcuronium and Tubocurarine in Anaesthetized Man

Krieg¹,

Crul²,

Booij³

1980

“…(iv) Blockade of cardiac vagus neuroeffector transmission. Neuromuscular blocking doses of gallamine, pancuronium, alcuronium and fazadinium can cause tachycardia in man (Smith and Whitcher, 1967;Kennedy and Kelman, 1970;Kelman and Kennedy, 1971;Blogg et al, 1973). Gallamine and pancuronium have been studied in detail and have been found to have atropine-like actions that are confined to the cardiac vagus neuroeffector junction (Riker and Wescoe, 1951;Saxena and Bonta, 1970).…”

Section: Unwanted Effects Of Non-depolarizing Neuromuscular Blocking mentioning

confidence: 99%

Pharmacology of Org NC 45 Compared with Other Nondepolarizing Neuromuscular Blocking Drugs

Marshall

Ágoston

Booij

et al. 1980

From results of pharmacological tests on the neuromuscular and autonomic blocking actions of a series of pancuronium analogues, Org NC 45, the C16 monoquaternary analogue of pancuronium, was selected for detailed study. Org NC 45 has a non-depolarizing mechanism of action, is more rapid in onset and shorter in duration of action than pancuronium. It shows less cumulation than pancuronium or tubocurarine, and is easily antagonized by anticholinesterases and aminopyridines. Org NC 45 exhibits a low propensity to release histamine. Its ability to inhibit cholinesterases is not likely to be important at neuromuscular blocking doses. Org NC 45 possesses negligible ganglion-blocking activity and there is a wide margin between neuromuscular and vagal blocking doses. Thus cardiovascular side-effects are unlikely to occur with the use of Org NC 45. It will hydrolyse mainly to its 3-hydroxy analogue which, like Org NC 45, possesses a wide margin between neuromuscular and vagal blocking doses. Org NC 45 has a high selectivity for the neuromuscular junction and represents a potentially useful addition to the armamentarium of clinically useful muscle relaxants.

“…In most of the previous studies of the haemodynamic effects of metocurine, no comparison has been made with other neuromuscular blocking agents. Furthermore, haemodynamic measurements have generally been made during a steady state as suggested by Kennedy and Kelman (1970). Therefore, we compared haemodynamic measurements after the administration of equipotent doses (Savarese, Ali and Antonio, 1977) of metocurine and pancuronium throughout the course of anaesthesia until surgery had started.…”

Section: Design Of the Studymentioning

confidence: 99%

Comparison of Haemodynamic Effects of Metocurine and Pancuronium in Patients With Coronary Artery Disease

Heinonen

Yrjölä

1980

The haemodynamic effects of large bolus doses of metocurine 0.45 mg kg-1 and pancuronium 0.1 mg kg-1 were compared in patients with coronary artery disease anaesthetized with diazepam, anileridine and nitrous oxide. Hypotension occurred more frequently after metocurine and was a result of a decrease in systemic vascular resistance. After pancuronium there was no increase in arterial pressure or heart rate, but a small increase in cardiac index. The decrease in heart rate after metocurine was the principal cause of the statistically significant difference in cardiac index between the two groups. Contrary to previous findings, metocurine did not attenuate circulatory responses to tracheal intubation. During surgical stimulation, two of the 10 patients of the pancuronium group developed significant ST segment depression and three patients had a rate-pressure product greater than 12 000 mm Hg beat min-1. However, the difference in rate-pressure product between the groups was not statistically significant.