Canadian Journal of Anesthesia, Vol 21, 68-78, Copyright © 1974 by Canadian Anesthesiologists' Society

The Effects of Precurarization with a Protective Dose of d-Tubocurarine in the Conscious Patient

¹ Department of Anaesthesia and Resuscitation, L'Hôtel-Dieu de Québec and Laval University

Precurarization with a protective dose of d-tubocurarine, 6 mg in the adult male, 4 mg in the female, was achieved in a series of 100 patients three minutes before the induction of anaesthesia. This procedure was well tolerated on both psychological and physiological bases. The patients displayed no modification of their respiratory mechanics and could exhibit normal coordinated movements of their hands, legs and head. Slight diplopia and a sensation of drowsiness occurred frequently.

Precurarization in the conscious patient affords effective protection against the untoward side-effects of succinylcholine and provides a more harmonious pattern to the pharmacokinetic profile of induction. With appropriate timing, endotracheal intubation can be performed at the peak of pharmacological activity of the involved drugs, d-tubocurarine, ultra-short acting barbiturate and succinylcholine.

This technique appears not only quite harmless, comfortable and permissible, but also mandatory in some cases. Our orientation is toward its use as a routine procedure.