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KMID : 0356920070520060681
Korean Journal of Anesthesiology
2007 Volume.52 No. 6 p.681 ~ p.686
Neuromuscular Blocking Actions of Hexamethonium, Rocuronium and (?)Vesamicol
Kim Mi-Jin

Lee Soo-Il
Lee Jong-Hwan
Lee Seung-Cheol
Abstract
Background: Hexamethonium (HM) and Rocuronium (R) are nAChR antagonists. However, there is some controversy as to whether R has a selective presynaptic effect. (?)Vesamicol (V) inhibits the transport of acetylcholine into the vesicles. This study compared the neuromuscular blockade of HM, R and V.

Methods: Hemidiaphragm-phrenic nerve preparations (male Sprague-Dawley rats [150?250 g]) were bathed in a Krebs solution maintained at 32oC and aerated with a mixture of 95% O2 and 5% CO2. Isometric forces were generated in response to 0.1 Hz, and 1.9-second 50 Hz with supramaximal stimulation (0.2 ms, rectangular) of the phrenic nerve. HM, R and V were added sequentially to achieve an 80?90% decrease in the ST. The ECs for ST, PTT and TF were calculated using a probit model. The antagonism indices of calcium (5 mM) and neostigmine (N) (250 nM) were assessed at the 85 ? 5% level.

Results: The potency of ST, PTT and TF were respectively, 5.92, 3.56 and 1.99 mM for HM, 10.81, 5.27 and 4.4 1¥ìM for R, and 19.4, 15.2 and 13.3¥ìM for V. The neuromuscular blockades of R were reversed by N but not by calcium. Those of V were not reversed by either of them. Calcium and N inhibited the decrease in ST and TF by HM, respectively.
Conclusions: The mechanism for how HM and R affect the neuromuscular blockade are different. V might not affect the release of acetylcholine. (Korean J Anesthesiol 2007; 52: 681¡­6)
KEYWORD
calcium, hemidiaphragm, hexamethonium, neostigmine, rocuronium, (?)vesamicol
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