Effect of preoperative consumption of glykoalcaloid containing nutrients on neuromuscular block mediated by succinylcholine and recovering from anesthesia

2. ABSTRACTEffect of Preoperative Consumption of Glykoalcaloid Containing Nutrients onNeuromuscular Block Mediated by Succinylcholine and Recovering fromAnesthesiaIn general anesthesia, muscle relaxing agents eases intubation and surgicalprocess. Succinylcholine is the only depolarizating muscle relaxing agent used currentlyand butirylcholinesterase is important in its metabolism. Glykoalcaloids inhibitsasetilcholinesterase and butirylcholinesterase. The aim of our study was to investigatethe effect of preoperative consumption of potatoes and other glykoalcaloid-containingnutrients on neuromuscular block mediated by succinylcholine and recovering fromanesthesia.Study was conducted with the approval of ethic commitee of Faculty. Forty foursubjects in ASA I-II risk group aged between 20-50 years old, planned for a two hourlasting elective surgery, were included in to the study. Subjects were randomly dividedinto two groups; those consuming diet containing glycoalcaloids as GA group (n=21)and those consuming diet with no glycoalcaloids as K group (n=23). Patients in GAgroup were fed with glykoalcaloid containing food and one portion of potatoes (200-400 mg) on the day prior to operation and in the last meal prior to fasting while patientsin K group were fed with food not containing glycoalcaloids. Premedication wasobtained by administration of 0.07 mg kg-1 midazolam after a fasting period of 6-8hours. Induction of anesthesia was achieved by thiopenthal (5-7 mg kg-1), fentanil (1µgr kg-1) and succinylcholine (1 mg kg-1) and maintained by 2.5 % sevofluran in 50 %Oxygen/air. Neuromuscular blockage was monitored by TOF Watch SX monitor. Formeasurement of serum butirylcholinesterase levels, five blood samples were obtained atdifferent times: during preanesthesic evaluation (basal level), 4-6 hours following to lastmeal, prior to induction, after termination of effect of succinylcholine and 24 hoursfollowing to last meal.Succinylcholine destruction time was significantly longer in GA group than in Kgroup (5.46±1.80 vs. 4.17±1.72, p<0.05). Awakening and recovering time was longer inGA group than in K group (5.40±0.70 vs. 4.43±0.72, p<0.05 and 25.14±226 vs.22.43±1.97, respectively p<0.05). Compared to the first period, enzyme levels were notsignificantly different in the second and the third periods, lower in the fourth period andslightly higher in the fifth period. Compared with basal levels, non-significant decreaseswere observed in GA group fed potatoe and SGA-containing food. Decrease inbutirylcholinesterase levels was more evident during the period in which the musclerelaxing effect of succinylcohline was disappeared. None of these differences observedin the level of enzyme was statistically significant (p<0.05).Nutrients consumed on days prior to surgery may significantly prolongateawakening and diet may cause variation in susceptibility of anesthetic agents.Consumption of food containing SGA?s on days preceding surgery can causeprolongation in neuromuscular blockage constituted by succinylcholine, awakening andrecovering time. Therefore it should be taken in consideration that diet of patients whoplanned to have surgery should not contain food SGA?s and especially potato.Nevertheless, more work is needed to make a clear conclusion.Keywords: Solanaceous glykoalcaloids, neuromuscular block,butirylcholinesterase.