Authors: Sato K.¹; Windisch K.¹; Matko I.²; Vizi E.¹

Source: BJA: British Journal of Anaesthesia, Volume 82, Number 6, June 1999 , pp. 904-909(6)

Publisher: Oxford University Press

Abstract:

We have studied the effect of non-depolarizing neuromuscular blocking agents, at concentrations present in serum during anaesthesia, on release of [³]-norepinephrine ([³H]NE) from superfused atrial appendage obtained during cardiac surgery from 48 patients. Three of the neuromuscular blocking agents (pancuronium, gallamine and rocuronium), which are known to cause an increase in heart rate during anaesthesia, increased stimulation-evoked release of [³H]NE. In contrast, (+)tubocurarine and pipecuronium, neuromuscular blocking agents that do not cause tachycardia, did not affect release of NE. Org 9487 significantly enhanced release while SZ1677 was ineffective, even at concentrations higher than those expected after administration of a 2XED₉₅ dose. Atropine enhanced release. These data suggest that the activation by acetylcholine (ACh) released from the vagal nerve reduces release of NE. This action contributes to lowering of heart rate. Therefore, any neuromuscular blocking agent with antimuscarinic actions and capable of increasing the release of NE may produce tachycardia.

Key words: neuromuscular block; sympathetic nervous system, norepinephrine; heart, heart rate; surgery, cardiovascular

Document Type: Research article

Affiliations: 1: Institute of Experimental Medicine, Hungarian Academy of Sciences, PO Box 67, H-1450 Budapest, Hungary 2: Department of Heart and Vascular Surgery, Semmelweis University of Medicine, Budapest, Hungary

Publication date: 1999-06-01

More about this publication?

• Founded in 1923, one year after the first anaesthetic journal was published by the International Anaesthesia Research Society, the British Journal of Anaesthesia remains the oldest and largest independent journal of anaesthesia. It became the journal of The College of Anaesthetists in 1990. The College was granted a Royal Charter in 1992. Although there are educational links between the BJA and the College, the journal retains editorial independence.

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