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  • Title: [Multiphasic neuromuscular blockade during and following regional application of succinylcholine in man (author's transl)].
    Author: Plötz J, Schreiber W, Braun J.
    Journal: Anaesthesist; 1981 Nov; 30(11):543-8. PubMed ID: 7316126.
    Abstract:
    The influence of the isolated arm technique on the development of the neuromuscular block induced by succinylcholine (suxamethonium) was investigated in 11 anesthetized patients using the adductor pollicis twitch method. A multiphasic course was shown: phase A (=occlusionphase) during ischemia; phases B1 and B2 (=post occlusion phases) after restoring circulation. The mean maximal depression of control twitch height increased from 60.4% in phase A to 75.2% in phase B1 and on up to 96.4% in phase B2. The mean onset time from releasing the tourniquet to first depression of twitch height amounted to 4.9 s in phase B1 and 27.8 s in phase B2. The multiphasic course is interpretated as the consequence of a temporary disequilibrium of muscle perfusion with the regional method. A neuromuscular effect after opening the tourniquet was evident in 3 out of 8 simultaneous studies on the control arm. An abnormal myotonic reaction was observed repeatedly in 1 patient.U
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