ABSTRACT
Resumen: La terapia electroconvulsiva consiste en la aplicación de corriente eléctrica a través de electrodos colocados en regiones frontotemporales (bilateral) o unilateral, con el objetivo de inducir una crisis convulsiva, controlada y monitorizada, que se realiza bajo anestesia general con la presencia de un equipo multidisciplinario. En este trabajo, se hace una reseña de la historia de la aplicación de anestésicos y relajantes musculares que se han utilizado para este tratamiento y de cómo el anestesiólogo se ha posicionado como un elemento fundamental para la aplicación del mismo.
Abstract: Electroconvulsive therapy consists of the application of electric current, through electrodes placed in frontotemporal regions (bilateral) or unilateral, with the aim of inducing a seizure, controlled and monitored, and performed under general anesthesia, with the presence of a multidisciplinary team. This paper reviews the history of the application of anesthetics and muscle relaxants, which have been used for this treatment and how the anesthesiologist has positioned himself as a fundamental element for its application.
ABSTRACT
Curare, a selective skeletal muscle relaxant, has been used clinically to reduce shivering and as an anesthetic auxiliary in abdominal surgery. It is also widely used in animal experiments to block neuromuscular junction activity. Effective doses of curare diminish muscle contraction without affecting brain function, but at higher doses it is known to be lethal. However, the exact dose of curare initiating muscle relaxation vs. lethal effect has not been fully characterized in mice. In this study we carefully examined the dose-response for achieving muscle inactivity over lethality in both male and female mice (C57BL6/J). The most striking finding of this study is that female mice were highly susceptible to curare; both the EDm and LDm were at least 3-fold lower than male littermates. This study shows that gender-specific differences can be an important factor when administering skeletal muscle relaxants, particularly curare or other analogous agents targeted to the neuromuscular junction.
Subject(s)
Animals , Female , Male , Mice , Curare/administration & dosage , Neuromuscular Nondepolarizing Agents/administration & dosage , Oxygen Consumption/drug effects , Sex Factors , Basal Metabolism/drug effects , Body Temperature/drug effects , Circadian Rhythm/drug effects , Curare/toxicity , Dose-Response Relationship, Drug , Feeding Behavior/drug effects , Immobilization , Kaplan-Meier Estimate , Neuromuscular Nondepolarizing Agents/toxicityABSTRACT
A fifty-eight years old male patient was given general anesthesia for the clipping of aneurysm on the posterior communicating artery. The respiration of the patient was controlled with Ohmeda 7000 anesthesia ventilator. During the surgery there appeared curare cleft on the capnogram which did not disappear after the administration of neuromuscular blocker, but disappeared after the change of the anesthesia ventilator with another one. After that another curare cleft was made by the transient obstruction of the outlet of the excess patient circuit gas of the new anesthesia ventilator. It may be said that inappropriately functioning pop-off valve of the anesthesia ventilator can be one of the causes of curare cleft on the capnogram.
Subject(s)
Humans , Male , Anesthesia , Anesthesia, General , Aneurysm , Arteries , Curare , Neuromuscular Blockade , Respiration , Ventilators, MechanicalABSTRACT
The effect of Sin on the transmission of the impulses through isolated rabbit superior cervical sympathetic ganglia in comparison with that of curare by the sucrose - gap method was studied.Inhibi -tory effect of Sin on the action potential was dose-dependent but no effect on the excitability and conductivity of preganglionic nerves. The ID50 of Sin and curare were 1.2 mM and 0.2 mM, respectively. The effect of Sin was reduced in high Ca2+ concentration solution, and enhanced under Ca2+ free solution. Neostigmine antagonized the effect of Sin.