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Reduced hypoxic chemosensitivity in partially paralysed man. A new property of muscle relaxants?
Authors:L. I. Eriksson  M.D.  Ph.D.
Affiliation:Department of Anaesthesiology and Intensive Care, Karolinska Hospital and Institute, Stockholm, Sweden
Abstract:Background: It was hypothesized that non-depolarizing neuromuscular blocking agents impair hypoxic chemosensitivity in man.
Methods: In thirty randomly allocated male volunteers the hypoxic and hypercarbic ventilatory responses were measured during partial paralysis (TOF ratio 0.70) due to either atracurium (n=10), pancuronium (n=10) or vecuronium (n=10).
Results: Hypoxic ventilatory responses were depressed by 306, 287 and 296% (mean SD) at steady-state infusion of atracurium, pancuronium and vecuronium, respectively. At a TOF ratio of >0.90, the HVR was not different from control measurements.
Conclusion: It is concluded that non-depolarizing neuromuscular blocking agents impair hypoxic ventilatory regulation. Further experimental studies are warranted to fully describe the mechanism(s) responsible for this interaction.
Keywords:Carotid body    chemosensitivity    hypercarbia    hypoxia    neuromuscular blocking agents    pancuronium    vecuronium    atracurium
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