Different magnitude of resistance to non-depolarizing muscle relaxants in dexamethasone-treated rat diaphragm associated with altered acetylcholine receptor expression

Chen, D; Yang, Meirong; Huang, Lizhen; Qiu, Yu‑Wei; Li, S T

doi:10.4238/2014.august.7.4

Cited by 10 publications

(21 citation statements)

References 22 publications

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“…The methods used here were modified from our previous studies. [ 10 11 ] The left hemidiaphragm with attached phrenic nerve, central tendon, and rib cage intact was rapidly moved and immediately immersed in Krebs solution that was maintained at 37°C and continuously bubbled with 95% O 2 /5% CO 2 . The composition of the Krebs solution was as follows (mmol/L): 137 NaCl, 4 KCl, 2 CaCl 2 , 1 MgCl 2 , 1 KH 2 PO 4 , 12 NaHCO 3 , and 6.5 glucose, with a pH 7.40 ± 0.5.…”

Section: Ethodsmentioning

confidence: 99%

Sepsis Strengthens Antagonistic Actions of Neostigmine on Rocuronium in a Rat Model of Cecal Ligation and Puncture

Tian

Wang

et al. 2016

Chinese Medical Journal

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Background:The antagonistic actions of anticholinesterase drugs on non-depolarizing muscle relaxants are theoretically related to the activity of acetylcholinesterase (AChE) in the neuromuscular junction (NMJ). However, till date the changes of AChE activity in the NMJ during sepsis have not been directly investigated. We aimed to investigate the effects of sepsis on the antagonistic actions of neostigmine on rocuronium (Roc) and the underlying changes of AChE activity in the NMJ in a rat model of cecal ligation and puncture (CLP).Methods:A total of 28 male adult Sprague-Dawley rats were randomized to undergo a sham surgery (the sham group, n = 12) or CLP (the septic group, n = 16). After 24 h, the time-response curves of the antagonistic actions of 0.1 or 0.5 μmol/L of neostigmine on Roc (10 μmol/L)-depressed diaphragm twitch tension were measured. Meanwhile, the activity of AChE in the NMJ was detected using a modified Karnovsky and Roots method. The mRNA levels of the primary transcript and the type T transcript of AChE (AChET) in the diaphragm were determined by real-time reverse transcription-polymerase chain reaction.Results:Four of 16 rats in the septic group died within 24 h. The time-response curves of both two concentrations of neostigmine in the septic group showed significant upward shifts from those in the sham group (P < 0.001 for 0.1 μmol/L; P = 0.009 for 0.5 μmol/L). Meanwhile, the average optical density of AChE in the NMJ in the septic group was significantly lower than that in the sham group (0.517 ± 0.045 vs. 1.047 ± 0.087, P < 0.001). The AChE and AChET mRNA expression levels in the septic group were significantly lower than those in the sham group (P = 0.002 for AChE; P = 0.001 for AChET).Conclusions:Sepsis strengthened the antagonistic actions of neostigmine on Roc-depressed twitch tension of the diaphragm by inhibiting the activity of AChE in the NMJ. The reduced content of AChE might be one of the possible causes of the decreased AChE activity in the NMJ.

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Section: Ethodsmentioning

confidence: 99%

Sepsis Strengthens Antagonistic Actions of Neostigmine on Rocuronium in a Rat Model of Cecal Ligation and Puncture

Tian

Wang

et al. 2016

Chinese Medical Journal

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“…Long-term exposure to both corticosteroids and NMBDs decreases nAChR at the neuromuscular junction and increases resistance to NMBDs. There is a slight difference between aminosteroids and benzylisoquinolinium types of NMBDs in response to long-term corticosteroid administration [ 50 51 ]. Long-term (> 4 weeks) administration of prednisolone in patients with chronic inflammatory bowel disease slowed the onset of action of rocuronium by 35% and reduced its duration of action by 25–30%, whereas there were no differences in the onset time of atracurium, although its duration of action was reduced by 20% [ 50 51 52 ].…”

Section: Drugs That Affect Ach Production and Release At The Neuromusmentioning

confidence: 99%

Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

Kim

Sung

Yang

2017

Korean J Anesthesiol

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Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action. Factors that affect the onset time include the potency of the NMBDs, the rate of NMBDs reaching the effect site, the onset time by dose control, metabolism and elimination of NMBDs, buffered diffusion to the effect site, nicotinic acetylcholine receptor subunit affinity, drugs that affect acetylcholine (ACh) production and release at the neuromuscular junction, drugs that inhibit plasma cholinesterase, presynaptic receptors responsible for ACh release at the neuromuscular junction, anesthetics or drugs that affect muscle contractility, site and methods for monitoring neuromuscular function, individual variability, and coexisting disease. NMBDs with rapid onset without major adverse events are expected in the next few years, and the development of lower potency NMBDs will continue. Anesthesiologists should be aware of the use of NMBDs in the management of anesthesia. The choice of NMBD and determination of the appropriate dosage to modulate neuromuscular blockade characteristics such as onset time and duration of neuromuscular blockade should be considered along with factors that affect the effects of the NMBDs. In this review, we discuss the factors that affect the onset time of NMBDs.

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“…However, the exact time interval required to develop drug interaction with NMBs could not be defined. Second, steroids are associated with inhibition of muscle-type nicotinic acetylcholine receptor function [24] and increase in the expression of this receptor at extracellular sites [25]. Increased expression of nicotinic acetylcholine receptor resulted in dexamethasone-induced hyposensitivity to non-depolarizing NMBs, and this hyposensitivity was highest in the group using atracurium and least in the group using rocuronium [25].…”

Section: Discussionmentioning

confidence: 99%

“…Second, steroids are associated with inhibition of muscle-type nicotinic acetylcholine receptor function [24] and increase in the expression of this receptor at extracellular sites [25]. Increased expression of nicotinic acetylcholine receptor resulted in dexamethasone-induced hyposensitivity to non-depolarizing NMBs, and this hyposensitivity was highest in the group using atracurium and least in the group using rocuronium [25]. However, a single injection of dexamethasone does not have a direct antagonistic effect on the nicotinic acetylcholine receptor, because the brief time interval from dexamethasone to NMB injection did not attenuate the neuromuscular block of rocuronium and cisatracurium in our study as well as that of Soltesz [7].…”

Section: Discussionmentioning

confidence: 99%

Effect of dexamethasone on the onset time and recovery profiles of cisatracurium

Kim

Jung

et al. 2017

Korean J Anesthesiol

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BackgroundThe effect of dexamethasone injection on cisatracurium-induced neuromuscular block was compared according to different injection time points.MethodsOne hundred seventeen patients were randomly assigned to three groups: 8 mg of dexamethasone injected intravenously 2–3 h before anesthesia (group A), just before anesthesia induction (group B), and at the end of surgery (control group). Three minutes after anesthesia induction, intubation was performed without neuromuscular blockers, and acceleromyography was initiated. All patients received 0.05 mg/kg cisatracurium; the onset time and recovery profiles were recorded.ResultsEighty patients were finally enrolled. The onset time (median [interquartile range], seconds) was significantly hastened in group A (520.0 [500.0–560.0], n = 30) compared to that in group B (562.5 [514.0–589.0], n = 22) (P = 0.008) and control group (586.5 [575.0–642.5], n = 28) (P < 0.001). The onset time in group B was faster than the control group (P = 0.015). The recovery time [mean (95% CI) minutes] was significantly hastened in group A [28.5 (27.3–29.6)] compared to that in group B [32.3 (31.0–33.6)] (P < 0.001) and control group [30.9 (29.9–31.8)] (P = 0.015). The total recovery time was significantly hastened more in group A [47.1 (45.5–48.6)] than group B [52.8 (51.6–54.0) minutes] (P < 0.001) and control group [50.5 (48.7–52.3) minutes] (P = 0.008).ConclusionsA single dose of 8 mg of dexamethasone hastened the onset and total recovery times of cisatracurium-induced block by approximately 15 and 9%, respectively if administered 2–3 h prior to surgery.

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Different magnitude of resistance to non-depolarizing muscle relaxants in dexamethasone-treated rat diaphragm associated with altered acetylcholine receptor expression

Cited by 10 publications

References 22 publications

Sepsis Strengthens Antagonistic Actions of Neostigmine on Rocuronium in a Rat Model of Cecal Ligation and Puncture

Sepsis Strengthens Antagonistic Actions of Neostigmine on Rocuronium in a Rat Model of Cecal Ligation and Puncture

Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

Effect of dexamethasone on the onset time and recovery profiles of cisatracurium

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