effects of acid-base balance and electrolyte disturbance in cases of late intestinal obstruction on neuromuscular blockade

ABSTRACT

The effects of changes in the acid base balance and electrolytes on the degree of neuromuscular blockade were studied on 60 adult patients undergoing gastrointestinal surgery. The cases included 30 normal patients and 30 with late intestinal obstruction. For the relaxation during surgery, three types of non-depolarizing muscle relaxants [d-turbocurarine, flaxedil and pancuronium] were used. A peripheral nerve stimulator was used to assess the degree of neuromuscular block. The study showed that metabolic acidosis and hypokalemia let to prolongation of the peripheral effects of three types of non-depolarizing muscle relaxants used with varying degree of affection. This was evidenced by decreased latency, increased time to return to the pre-relaxant response after reversal, and marked prolongation in the recovery time. The study showed that pancuronium is the drug of choice in late cases of intestinal obstruction, being easily reversed and not greatly affected by electrolytes and acid-base disturbances