Effect of Aminophylline on Atracurium Induced Neuromuscular Block | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 29, Volume 71, Issue 5, April 2018, Pages 3254-3260 PDF (357.31 K) | ||
| Document Type: Original Article | ||
| Author | ||
| Mostafa ME El-Hamamsy, Josef M Botros, Hani M Yassen, Moaz I Mohammed** | ||
| Department of Anesthesiology, Faculty of Medicine, Fayoum University | ||
| Abstract | ||
| Background: theophylline is a naturally occurring methylxanthine that plays a role in various body functions through different mechanisms which include: phosphodiesterase enzyme inhibition, adenosine receptor antagonism etc. Its action on skeletal muscles to counteract fatigue and /or paralysis is through increasing acetylcholine release from motor nerve ending and increasing calcium concentrations within the muscle fiber itself. These combined effects therefore can antagonize nondepolarizing neuromuscular blockers through competitive antagonism in generally anesthetized patients. By the use of neuromuscular monitors, this effect could be evaluated and also to assess doses for reversal of residual drug-induced neuromuscular paralysis. Aim of the Study: the aim of this study was to evaluate the effect of theophylline on facilitating the recovery from atracurium induced neuromuscular blockade. Patients and Methods: this study was performed on sixty (60) patients undergone elective surgeries had been expected to be about one-hour duration, with balanced general anesthesia after obtaining approval of the Ethical and Scientific Committee of Al Fayoum University, and written informed consents from patients. In this study, we used theophylline to antagonize atracurium induced muscle paralysis. Results: the results showed effective antagonism of atracurium paralyzing effect and rapid recovery from this paralysis. Conclusion: theophylline antagonizes atracurium induced neuromuscular blockade by several mechanisms either at the prejunctional or postjunctional level by AR antagonism or PDI or by RyR channel activation. Recommendations: we recommend further studies to be done on different categories of patients as diabetics, cardiac patients, elderly and etc. to assess its safety among those patients. We recommend further studies to be done on different categories of patients as diabetics, cardiac patients, elderly and etc. to assess its safety among those patients. | ||
| Keywords | ||
| Phosphodiesterase enzyme inhibition; Theophylline; Neuromuscular blockade; atracurium; Neuromuscular monitoring; Train of four (TOF) | ||
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