Potentiation of neuromuscular blockade by calcium channel blockers

Tokai J Exp Clin Med. 1994 Dec;19(3-6):131-7.

Abstract

A significant reduction was noticed in the amount of vecuronium needed to maintain steady neuromuscular blockade at 20% twitch height (T1) in patients given nicardipine intraoperatively. Bolus injection of either nicardipine or diltiazem during constant infusion of vecuronium produced transient depression of T1 and the train-of-four ratio (TOFR). Reversal of neuromuscular blockade with a choline esterase inhibitor (neo-stigmine) was not retarded by previous administration of Ca-channel blockers but concurrent administration of anticholine-esterase agent and Ca-channel blockers caused a delay in recovery from motor blockade. Monitoring of neuromuscular junction activity is strongly recommended whenever a large cumulative dose of Ca-channel blockers is used.

MeSH terms

  • Adult
  • Aged
  • Calcium / pharmacology
  • Drug Synergism
  • Evoked Potentials / drug effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Relaxation / drug effects
  • Neuromuscular Junction / drug effects*
  • Neuromuscular Junction / physiology
  • Nicardipine / administration & dosage
  • Nicardipine / pharmacology*
  • Vecuronium Bromide / administration & dosage

Substances

  • Vecuronium Bromide
  • Nicardipine
  • Calcium