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Acidosis and Neuromuscular Blockade

The effect of different types of acidosis on sensitivity to neuromuscular blocking agents was studied in vivo on the tibialis muscle of cats and in vitro in the phrenic nerve diaphragm preparation of the rat. In vivo metabolic acidification was caused by diffusion of weak organic acids, which penetrate easily into the cell and imitate closely the state of metabolic acidosis in man. Respiratory acidosis was caused by inhalation of 10% carbon dioxide in oxygen. In the in vitro experiments, acidification was caused by titration with the same acids as well as hydrochloric acid. pH was lowered to levels just above 7.0. Blank in vivo studies showed that the metabolic acidosis by itself causes no significant depression of indirect muscle contraction, while respiratory acidosis causes only a slight depression. A minor depression was seen in the blank in vitro metabolic acidosis studies.