Lee C
Br J Anaesth. 1976 Nov;48(11):1097-1102. doi: 10.1093/bja/48.11.1097.
Twelve adults receiving halothane-nitrous oxide anaesthesia for elective surgery were investigated during suxamethonium-induced neuromuscular block, using the train-of-four twitch for measurement of both the degree of block and the magnitude of fade (decrease in fourth-to-first ratio). The residual neuromuscular block resulting from prolonged exposure to suxamethonium could be antagonized by bolus injections of suxamethonium itself, in doses which increased the block in Phase I. When self-antagonism was demonstrated, larger doses were necessary to increase the residual block, but only after overcoming the self-antagonizing effect. A biphasic response, first antagonizing then increasing the block, was observed following injection of a single bolus of suxamethonium. The self-antagonizing effect was more obvious in the fourth twitch of the train-of-four, resulting in a marked decrease in train-fo-four fade (increase in train-of-four ratio). It was concluded that self-anatagonism may be an important cause of tachyphylaxis in suxamethonium-induced neuromuscular block in man.
在琥珀胆碱诱导的神经肌肉阻滞期间，对12名接受氟烷-氧化亚氮麻醉进行择期手术的成年人进行了研究，使用四个成串刺激来测量阻滞程度和衰减幅度（第四与第一比值的降低）。长时间暴露于琥珀胆碱导致的残余神经肌肉阻滞可用琥珀胆碱本身大剂量推注来拮抗，这些剂量在I期会增加阻滞。当证明有自我拮抗作用时，需要更大剂量才能增加残余阻滞，但只有在克服自我拮抗作用之后才行。注射单次推注琥珀胆碱后观察到双相反应，先是拮抗然后增加阻滞。自我拮抗作用在四个成串刺激的第四个刺激中更明显，导致四个成串刺激衰减明显减少（四个成串刺激比值增加）。得出的结论是，自我拮抗可能是人类琥珀胆碱诱导的神经肌肉阻滞中快速耐受性的一个重要原因。
