[Anesthetic treatment of periodic familial hypokalemic paralysis. Report of a case]. / Tratamiento anestésico de la parálisis periódica familiar hipopotasémica. A propósito de un caso.

Periodic familiar hypopotassemic paralysis (PFHP) is a rare dominant autosomally transmitted genetic disease characterized by intermittent attacks of muscle weakness. A patient with PFHP was successfully given general anesthesia for 2 operations using atracurium as the muscle relaxant. For a third operation he was given a paravertebral block.

[Induction-intubation sequence in neuroanesthesia. Usefulness of vecuronium in fractionated doses]. / Secuencia de inducción-intubación en neuroanestesia. Utilidad del vecuronio en dosis fraccionadas.

Muscular relaxant vecuronium bromide (Norcuron R, Organon Teknika Española, S.A.) was administered to 20 patients undergoing intracranial surgery with general anesthesia at a dose of 0.01 mg/kg weight followed by 0.1 mg/kg (intubation dose) four minutes later. Two minutes after the second dose and under careful manual mechanical ventilation with O2 100%, a laryngoscopy was performed to evaluate the conditions for intubation. Mean arterial pressure, heart rate, PaO2, and PaCO2 were measured at baseline and immediately before laryngoscopy. Neuromuscular function was monitored observing the response to a train of four stimuli applied on the cubital nerve. During the operation a continuous infusion of vecuronium at a rate of 1 microgram/kg/min was maintained. Conditions for intubation were excellent in 18 patients and good in two cases. Mean heart rate and PaCO2 did not show significant variations. In contrast, during prelaryngoscopy mean arterial pressure decreased and PaO2 increased with respect to the baseline values. During surgery all patients showed a good clinical relaxation. Thus, we believe that vecuronium is a good muscular relaxant agent, safe, and effective to be used in neurosurgery.