toxiferine and Kidney-Failure--Chronic

Topics: Adult; Alcuronium; Anesthesia, General; Female; Humans; Kidney Failure, Chronic; Kidney Transplantation; Lupus Erythematosus, Systemic; Myasthenia Gravis; Toxiferine

Alcuronium 0.16 mg kg-1 was used to provide neuromuscular blockade in patients with chronic renal failure undergoing renal transplantation. Relaxation was found to be adequate for intubation and surgery. There were minimal alterations to cardiovascular variables. The dose required was small, and complete reversal occurred with neostigmine. Although the number of patients is small, the drug may be of value as an alternative to tubocurarine or pancuronium in such patients.

Topics: Adolescent; Adult; Alcuronium; Blood Pressure; Female; Heart Rate; Humans; Intubation, Intratracheal; Kidney Failure, Chronic; Kidney Transplantation; Male; Time Factors; Toxiferine

Signs of neuromuscular block were evident more than 20 hours after the administration of alcuronium to an anuric patient. Complete recovery occurred during haemodialysis. We therefore decided to study the dialysance of three radioactive non-depolarising relaxants during haemodialysis of four patients with chronic renal failure. Although dimethyl tubocurarine and alcuronium were equal as regards dialysance, the concentration of the former, in plasma, falls faster than does alcuronium. It is believed that a larger volume of distribution occurs with dimethyl tubocurarine. In spite of the fact that the dialysance of muscle relaxants is small, haemodialysis might lower the concentration of these substances in the plasma to a level below the critical point which produces paralysis.

Topics: Acute Kidney Injury; Adult; Alcuronium; Female; Gallamine Triethiodide; Humans; Kidney Failure, Chronic; Male; Middle Aged; Renal Dialysis; Time Factors; Toxiferine; Tubocurarine

Topics: Adjuvants, Anesthesia; Adolescent; Adult; Aged; Anesthesia, General; Carbazoles; Child; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Toxiferine