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Korean Journal of Anesthesiology 1980;13(3):282-285.
DOI: https://doi.org/10.4097/kjae.1980.13.3.282   
Prolongation of the Neuromuscular Effect of Succinylcholine by Hexafluorenium .
Ae Ra Kim, Jae Kyu Jeon
Department of Anesthesiology, Presbyterian Medical Center, Keimyung University School of Medicine, Taegu, Korea.
Abstract
Hexafluorenium has not been popular in clinical anesthesia due to the occurrence of bronchospasm, cardiac arrest, arrhythmias and histamine release reported from its use since it was introduced in 1954. The authors were primarily interested in studying this drug because it has fascinating dual effects of a weak nondepolarizing action at the myoneural junction and a marked antipseudocholinesterase activity. Forty cases were studied in two different groups. In the 1st group of 20 patients, hexafluorenium, 0. 4mg/kg, was given for intubation. In the 2nd group of 20 patients, hexafluorenium followed by succinylcholine was given after an intubsting dose of succinylcholine had worn off. As a result of this study, we can summarize as follows: 1) This combination of hexafluorenium and succinylcholine provides good relaxation for abdominal surgery. 2) Duration of action of succinylcholine varied, ranging from 30 to 40 minutes. 3) In the 1st group, most of the 20 patients complained of discomfort:, with nausea and oral secretion, but muscular fasciculation elicited by succinylcholine injection was not observed. 4) In the 2nd group, untoward effects, such as nausea and oral secretion, were not observed but it was cumbersome to calculate adequate dose of the drugs in anesthesia practice. 5) No bronchospasm or cardiovascular effects were noted except for one suspected case. 6) It would be acceptable to use this combination of drugs when used with caution and also it is worthwhile to study to understand the physiology of muscle relaxation, because it has a peculiar dual action of muscle relaxation.


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