Hexafluorenium bromide

Forty patients, half of them with normal kidney function, the other half anephric were included in the study. All received diphenhydramine, meperidine and atropine for premedication and droperidol, fentanyl, N2O and O2 for anesthesia. For endotracheal intubation and further relaxation 0.3 mg/kg hexafluorenium, followed in 5 minutes by 0.2 mg/kg succinylcholine were given intravenously. Anesthesia was maintained by 0.5 micrograms/kg increments of fentanyl, muscle relaxation by increments of 0.15 mg/kg or less hexafluorenium and 0.2 mg/kg or less succinylcholine, depending on the surgical time requirements. The drop in serum potassium concentration was sustained and similar in both groups. In the anephric group the drop after induction of neurolept anesthesia was statistically significant. The concentration remained low in both groups over the entire observation period. Unchanged serum sodium excluded hemodilution and the fact that there was no significant change in PvCO2 and pH mitigates against alkalosis as the cause for the observed drop. The anesthesia and muscle relation, as described, appears to be a suitable and hazard free alternative to other techniques.

The influence of the primary bile salts taurocholate and chenodeoxycholate on the neuromuscular blockade of the non-depolarizing drugs Org 6368, pancuronium, Org NC 45 and hexafluorenium was studied in cats. An increase in the effects of these agents, all possessing widely varying molecular structures, was found following administration of the bile salts. The bile salt concentrations in plasma were similar to those obtained after 9-10 days of extrahepatic cholestasis in cats. The effect of Org NC 45, a new monoquaternary analogue of pancuronium, was increased more than that of pancuronium. This increase in effect is probably a result of inhibition of the hepatic uptake of the neuromuscular blocking drugs. The neuromuscular blocking effect of gallamine was not influenced significantly by the administration of bile salts.