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KMID : 0356919920250010172
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Korean Journal of Anesthesiology
1992 Volume.25 No. 1 p.172 ~ p.176
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Unusual Prolonged Recovery of Succinylcholine-induced Neuromuscular Block Following Neostigmine
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Abstract
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We report a case of slow recovery of the neuromuscular block induced by succinylcholine(SCC)immediately after administration of neostigmine for the reversal of pancuronium.
Left hemithyroidectomy was performed in a 41 kg female patient under general endotracheal inhalation anesthesia with 50%-nitrous oxide and 2.0%-enflurane. Four mg of pancuronium was used for muscular relaxation to facilitate the controlled
ventilaion on
the anesthesia ventilator. At the end of the operation, one and a half hours from the injection of pancuronium, 10mg of pyridostigmine was administered to reverse the neuromuscular blockade, Five minutes later, 25mg of succinylcholine was given
for
reintubation.
Following this event, train-of-four stimuli was applied under the uncalibrated mode with Datex (r) Relaxograph because apnea followed by SCC appeared for more than 30 minutes. Neuromuscular monitoring revealed fade to less than 50% of the T4
ratio.
The ventilator was applied for the recovery of neuromuscular blockade for one hour. There was no more late complications after transfer to the ward.
The literature relating to this iatrogenic complication and phase Ⅱblock after SCC is reviewed and discussed.
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