Halothane Anaesthesia and Suxamethonium II The Significance of Preoperative Gallamine Administration

Abstract

Preoperative administration of gallamine was evaluated during inhalation anaesthesia with nitrous-oxide and halothane with two administrations of suxamethonium 1 mg/kg body weight, 5 min apart. Sixty healthy patients were randomly divided into three groups and preanaesthetic gallamine, 0.3, 0.4 or 0.5 mg/kg body weight, respectively was administered intravenously 3 min before induction, according to the allocation. Just before induction of anaesthesia the patients were examined for signs and symptoms of partial curarization. After induction of anaesthesia by nitrous-oxide-oxygen-halothane, suxamethonium 1 mg/kg was given intravenously. Exactly 5 min later the same dose was repeated. ECG was monitored continuously and serum potassium, Pao2 and Paco2 were measured at appropriate intervals. It was found that none of the examined doses of gallamine gave any reliable protection against serious bradyarrhythmias after repeated doses of suxamethonium. Furthermore the higher doses of gallamine caused an unacceptably high frequency of patients with tachycardia and signs and symptoms of partial curarization.

Halothane Anaesthesia and Suxamethonium III. Atropine 30 s Before a Second Dose of Suxamethonium During Inhalation Anaesthesia: Effects and Side‐Effects

“…The arrhythmias were more frequent in the higher atropine dosage groups, and in some of the patients they were serious (Fig, 4). These results contrast sharply with our previous findings that no ventricular arrhythmias occurred following a second dose of suxamethonium in 120 patients given either atropine or gallamine 5 rnin before induction (VIBY-MOGENSEN et al 1976, WISBORG et al 1977.…”

“…We have shown previously, however, that preanaesthetic intravenous injection of atropine before halothane inhalation anaesthesia does not protect against severe bradycardia following the second dose of suxamethonium, unless doses of atropine are used which cause potentially dangerous tachycardia (VIBY-MOGENSEN et al 1976). In another study we found that precurarization with gallamine does not give any reliable protectionnot even in doses causing marked tachycardia and an otherwise unacceptable incidence of side effects (WISBORG et al 1977).…”

Halothane Anaesthesia and Suxamethonium III. Atropine 30 s Before a Second Dose of Suxamethonium During Inhalation Anaesthesia: Effects and Side‐Effects

“…Thus 12 (15%) out of 80 patients given atropine 0.01 mg/kg or more (95% confidence limits: 8.00-24.78%) developed ventricular arrhythmias occurring after the second injection of suxamethonium. These results contrast sharply with our previous findings that no ventricular arrhythmias occurred following a second dose of suxamethonium in 120 patients given either atropine or gallamine 5 rnin before induction (VIBY-MOGENSEN et al 1976, WISBORG et al 1977. 4).…”

“…Several methods have been proposed to prevent this bradycardia : for example, the preanaesthetic administration of atropine or a small dose of a nondepolarizing muscle-relaxant (LEIGH et al 1957, LUPPRIAN & CHURCHILL-DAVIDSON 1960, KARHUNEN et al 1972. In another study we found that precurarization with gallamine does not give any reliable protectionnot even in doses causing marked tachycardia and an otherwise unacceptable incidence ofside effects (WISBORG et al 1977). In another study we found that precurarization with gallamine does not give any reliable protectionnot even in doses causing marked tachycardia and an otherwise unacceptable incidence ofside effects (WISBORG et al 1977).…”