• Anaesth Intensive Care · Apr 1993

    Phenytoin-induced resistance to vecuronium.

    • P R Platt and N M Thackray.
    • Department of Anaesthesia, Sir Charles Gairdner Hospital, Perth, Western Australia.
    • Anaesth Intensive Care. 1993 Apr 1; 21 (2): 185-91.

    AbstractChronic phenytoin therapy causes resistance to some nondepolarising muscle relaxants. We have confirmed that this resistance is seen with vecuronium and suggest that at least a week of phenytoin therapy is required for a significant effect to develop. The mechanism of this resistance is not known. We have shown that an exaggerated rise in serum potassium after succinylcholine does not occur in patients with demonstrated resistance to vecuronium from chronic phenytoin therapy. This would suggest that significant extrajunctional acetylcholine receptor proliferation is an unlikely mechanism.

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