Increased d-tubocurarine requirement following major thermal injury

Abstract

In five patients with burns of more than 25 per cent of body surface area both the total dose of dTc administered intravenously and the serum concentration necessary to attain a given twitch depression were greatly increased, compared with values for healthy normal patients. The recovery of neuromuscular blockade seen at serum concentrations which would give 100 per cent twitch depression in normal subjects indicates that neither increased urinary excretion nor increased loss of dTc through burn wounds caused these changes. Although this study was not specifically directed to elucidate the etiology of the increased dTc requirement, the authors have speculated on the possible etiologic mechanisms.