The Interactions of Neuromuscular Blocking Agents in Man

Hexafluorenium-Suxamethonium Relaxation for Abdominal Surgery

“…Mostert and Kiindig (1964) put forward the hypothesis of hexafluorenium causing histamine release to explain their own and other cases of severe bronchospasm. Van Hemert and Pearce (1965) were unable to confirm the findings of Mostert and Kiindig concerning histamine release and, in common with Duncalf et al (1965), were unable to confirm any adverse circulatory effects of hexafluorenium. Histamine release is possibly due to a high dosage of suxamethonium (Paton, 1959).…”

“…There has been much discussion of the mode of action of hexafluorenium. Foldes (Torda et al, 1967) demonstrated a weak non-depolarizing action as well as a marked anticholinesterase action.…”

“…It has been used by a number of workers-notably by Rizzi (1956), Foldes (1960) and Kok, Sher and Kruger (1962)-to potentiate suxamethonium for muscular relaxation, mainly in prolonged operations. There have been some reports of the occurrence of bronchospasm (Selvin and Howland, 1959), as well as of cardiac arrhythmias and histamine release (Mostert and Kiindig, 1964), but the liability of hsxafluorenium to produce these side effects has been strongly refuted by a number of workers (Foldes, 1960;Duncalf et al, 1965;van Hemert and Pearce, 1965). The present investigation was undertaken to see if the hexa-fluorenium-suxamethonium combination would be useful in abdominal operations of short duration.…”