Ventilation and Neuromuscular Blocking Drugs
In 1811 the British surgeon Brodie demonstrated that the lethal effect of crude durare in cats could be overcome by assisted ventilation to the animal (1). Curare was introduced into clinical anaesthesia in 1942 and twelve years later, Beecher and Todd reviewed surgical mortality in paralysed and nonparalysed patients and found that the perioperative death rate was six time higher among paralysed patients than non-paralysed patients (2). Furthermore, two thirds of the mortality in the paralysed patients was associated with ventilatory collaps and hypoxia, while the other third was primarily related to circulatory failure. Interestingly, most patients receiving curare were partially paralysed and were able to maintain spontaneus breathing without endotracheal intubation. Hence, it can be expected that the high incidence of ventilatory failure among partially paralysed subjects was due to impared airway maintenance and lack of controlled ventilation.
KeywordsNeuromuscular Block Carotid Body Ventilatory Response Neuromuscular Blocking Agent Adductor Pollicis
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