Od kurary do esmeronu – czy to przepaść, czy tylko różnica?^*)

Elżbieta Sokół-Kobielska

Summary
Traditional balanced anaesthesia comprises sleep, analgesia and muscle relaxation. Prior to the introduction of neuromuscular blocking drugs, muscle relaxation to facilitate surgical access was achieved by using deep inhalational or intravenous anaesthesia. Widespread use of relaxants in anaesthesia started in Canada in 1942 when Griffith and Johnson applied curare during surgery of the patient who underwent appendicectomy. The first reported use in Europe of curare was in 1946 by Gray and Halton. One year later the muscle relaxation was introduced in Poland by Stanisław Aleksander Pokrzywnicki – the first Polish qualified anaesthesiologist. Only when muscle relaxants became available was it possible to perform tracheal intubation easily and the patient could be maintained at lighter level of general anaesthesia. Once the use of curare became accepted as a means of producing relaxation during anaesthesia the search started for alternative more specific drugs. Nowadays curare is no longer in use being replaced by modern relaxants. Their usefulness in clinical practice is determined by better pharmacokinetic and phamacodynamic properties and less side-effects. How big is the difference between curare and modern neuromuscular blocking agents? The question is still opened.

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