الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
INTRODUCTION
The first use of a neuromuscular blocking agent in anaesthesia by Griffith
and Johnson (1942), not only revolutionized the practice of anaesthesia, but also
started the modem era of surgery and made possible the explosive development
of intrathoracic, neurological and organ transplant surgery.
At first only the purified extract of chondodendron tomentosum and
somewhat latter its purified alkaloid d-tubocurarine (dtc) was available for
clinical use.
The difficulties encountered in obtaining uninterrupted supplies of raw
material for the production of dtc and the occasional complications
(hypotension, bronchoconstriction) caused by the ganglion blocking and/or
histamine releasing activity of dtc prompted the search for synthetic
neuromuscular blockers. Of the numerous compounds synthesized and tested,
only relatively few gained popularity. The first of these was gallamine
triethiodide (flaxedil) soon followed by decamethonium bromide and dimethyl
tubocurarine chloride (metocurine) and suxarnethonium (Folds, 1957).
Alcuronium chloride (Alloferin), in spite of the favourable results obtained with
it in clinical trials (Folds et al., 1963) it gained popularity only in Europe.
Pancuronium bromide (pavulon) was introduced in the late sixties (Baired and
Reid, 1967), soon became and still the most widely used neuromuscular blocker.
Two short acting non-depolarizing compounds have been introduced into
clinical practice vecuronium bromide (Norcuron) and atracurium besylate
(Tracurium). Mivacurium (BWB 1090U) short acting non-depolarizing muscle