A Blueprint for a Fast Acting Non-Depolarizing Drug

  • François Donati
Conference paper


Ideally, the anesthesiologist should have a non-depolarizing muscle relaxant with an onset time of one minute or less, and a duration no greater than 5–10 min, so that the risk of aspiration of gastric contents is minimized, and alternate plans can be worked out if tracheal intubation is not successful. So far, only succinylcholine has such an ideal neuromuscular profile. This situation is not due to the depolarizing nature of succinylcholine block, but to a combination of pharmacokinetic and pharmacodynamic factors which have not been met with non-depolarizing neuromuscular blockade. To obtain fast onset and rapid recovery, peak drug levels should be reached rapidly at the neuromuscular junction, these levels should be adequate for blockade, and the drug should be cleared rapidly.


Onset Time Neuromuscular Junction Fast Onset Adductor Pollicis Orbicularis Oculus 
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  1. [1]
    Chauvin M, Lebreault C, Duvaldestin P. The neuromuscular effect of vecuronium on the human diaphragm. Anesth Analg 1987; 66: 117–122PubMedCrossRefGoogle Scholar
  2. [2]
    Donati F, Meistelman C, Plaud B. Vecuronium neuromuscular blockade at the adductor muscles of the larynx and pollicis. Anesthesiology 1991; 74: 833–837PubMedCrossRefGoogle Scholar
  3. [3]
    Donati F, Meistelman C, Plaud B. Vecuronium neuromuscular blockade at the diaphragm, the orbicularis oculi and adductor pollicis muscles. Anesthesiology 1990; 73: 870–875PubMedCrossRefGoogle Scholar
  4. [4]
    Law Min JC, Bekavac I, Glavinovic MI, Donati F, Bevan DR. Iontophoretic study of speed of action of various muscle relaxants. Anesthesiology 1992; 77: 351–355CrossRefGoogle Scholar
  5. [5]
    Bowman WC, Rodger IW, Houston J, Marshall RJ, Mclndewar LI. Structure:action relationships among some deacetoxy analogues of pancuronium and vecuronium in the anesthetized cat. Anesthesiology 1988; 69: 57–62PubMedCrossRefGoogle Scholar
  6. [6]
    Kopman AF. Pancuronium, gallamine, and d-tubocurarine compared: Is speed of action inversely related to drug potency? Anesthesiology 1989; 70: 915–920CrossRefGoogle Scholar
  7. [7]
    Donati F, Meistelman C. A kinetic-dynamic model to explain the relationship between high potency and slow onset time for neuromuscular blocking drugs. J Pharmacokinet Biopharm 1991: 19: 537–552PubMedCrossRefGoogle Scholar
  8. [8]
    Lien CA, Schmith VD, Wargin WA, Kudlak TT, Savarese JJ. Pharmacokinetics and pharmacodynamics of mivacurium strereoisomers during a two-step infusion. Anesthesiology 1992; 77: A910CrossRefGoogle Scholar
  9. [9]
    Ducharme J, Varin F, Bevan DR, Donati F. Importance of early blood sampling on vecuronium pharmacokinetic and pharmacodynamic parameters. Clin Pharmacokinet 1993; 24: 507–518PubMedCrossRefGoogle Scholar

Copyright information

© Springer Japan 1995

Authors and Affiliations

  • François Donati
    • 1
  1. 1.Department of AnesthesiologyHotel-Dieu de MontrealMontrealCanada

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