[Resistance to non-depolarizing myorelaxants. Our experience with 3 clinical cases]

The Authors report their own experience in three patients that showed reduced sensitivity to atracurium or vecuronium. Two patients were affected by neoplastic diseases and one by hand trauma. Doses of 0.5 mg/kg of atracurium and 0.08 mg/kg of vecuronium were unable to establish a complete neuromuscular blockade. The Authors review the main clinical situations in which resistance to non-depolarizing muscle relaxants is known: burns, hepatic diseases, chronic therapy with anticonvulsant drugs. Possibly, such events are due to fast elimination of the drug, or to an increased number of acetylcholine nicotinic receptors, or to an unknown acutely acting circulating factor, or to increased binding of the drug to plasma proteins. Up to date, no well-established explanation is available.