A History of Neuromuscular Block and Its Antagonism

Abstract

Fifteenth century South American explorers knew of the indian arrowhead poison “ourari” or curare. The eighteenth century physician Bancroft brought samples of crude curare from South America, and in 1808 Brodie showed that it was safe if ventilation continued artificially. In 1846, Bernard demonstrated that curare acted where the nerve impulse reached the muscle, the neuromuscular junction. In 1912, surgeon Lawen used curare for tracheal intubation and surgical procedures. The idea did not catch on. In the 1930s, Gill brought curare from South America to the US. With Squibb chemists, pharmacologist McIntyre purified the crude extract as Intocostrin, which Holaday assayed for potency with the rabbit head drop test. By standardizing the concentration, this allowed Intocostin’s study. In 1939, psychiatrist Bennet reported that Intocostrin prevented compression fractures from convulsive therapy. Cullen then tried Intocostrin in dogs, but because it seemed to cause bronchspasm said it had “no place in anesthesia”.

Keywords

Neuromuscular block history Antagonism and neuromuscular block history Curare history of anesthesia Waterton Charles Sugammadex 

Notes

Acknowledgment

This work was supported by the University of California Department of Anesthesia and Perioperative Care.

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Copyright information

© Edmond I Eger, MD 2014

Authors and Affiliations

  1. 1.Department of Anesthesia and Perioperative MedicineUniversity of CaliforniaSan FranciscoUSA

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