Evidence has been presented to show that a second dose of suxamethonium is capable of producing a severe bradycardia in man. This response may be effectively prevented by the prior administration of certain non-depolarizing muscle relaxants namely tubocurarine, alcuronium, c-toxiferine and pancuronium in quantities of one-quarter or less of their muscle relaxant level. It is suggested that suxa...

To the Editor:—Schreiber et al. noted an association between larger doses of succinylcholine and a reduced incidence of fasciculation and myalgia. However, pretreatment with a nondepolarizing neuromuscular blocker is also associated with a reduced risk of fasciculation and myalgia. It is a common practice for clinicians to use a larger dose of succinylcholine when they have provided pretreatmen...

Anaesthesiologists must be prepared to deal with pharmacokinetic and pharmacodynamic (PD) differences in morbidly obese individuals. As drug administration based on total body weight can result in overdose, weight-based dosing scalars must be considered. Conversely, administration of drugs based on ideal body weight can result in a sub-therapeutic dose. Changes in cardiac output and alterations...

To the Editor:—Schreiber et al. noted an association between larger doses of succinylcholine and a reduced incidence of fasciculation and myalgia. However, pretreatment with a nondepolarizing neuromuscular blocker is also associated with a reduced risk of fasciculation and myalgia. It is a common practice for clinicians to use a larger dose of succinylcholine when they have provided pretreatmen...

Neuromuscular disorders like myotonic dystrophy (dystrophia myotonica or Steinert's disease) and spinal muscular atrophy are associated with perioperative complications related to muscle weakness. These patients have an increased sensitivity to non-depolarising neuromuscular blocking agents, which can lead to postoperative residual curarization (PORC) and its associated respiratory complication...