NEUROMUSCULAR EFFECTS OF HALOTHANE, SUXAMETHONIUM AND TUBOCURARINE IN A MYASTHENIC UNDERGOING THYMECTOMY

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Abstract
SUMMARYThe neuromuscular effects of halothane, suxamethonium, and tubocurarine were observed in a female patient undergoing thymectomy because of myasthenia clinically localized to extraocular muscles. The twitch response was compared with that obtained in a control group of five non-myasthenic patients. In the control non-myasthenic group, halothane 2 per cent increased the twitch response, suxamethonium 20 mg produced complete neuromuscular block, whilst tubocurarine 3 mg produced partial block which rapidly recovered. On the other hand, in the myasthenic patient, halothane did not affect the twitch response, suxamethonium only produced partial neuromuscular block, whilst tubocurarine produced severe block associated with marked tetanic fade and post-tetanic facilitation. This altered response to halothane, resistance to depolarizing agents, and sensitivity to antidepolarizing agents were demonstrated in muscles of the body that did not show clinical weakness.

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