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The use of muscle relaxants in stomatology
Abstracts of Current ORAL Sull’uso dei miolitici in Stomatologia. Clinica Odontoiatria R. Bandettini.
Literature SURGERY (The Use of Muscle Relaxants 6: 153, May,
in Stomatology.)
1951.
This report on the drugs which are administered in t.he treatment of nourologiczal disorders, such as spasticity, rigidity, and involuntary movements, deals chiefly and PXelusively with the action of myanesin (Mephenesin, Tolserol). First described by Rerger and Bradley in 1946, myanesin when administered in clinical doses (10 to 40 mg./kg.) acts with depressant result on the brain stem (medulla oblongata). This selective action of depression of myanesin on the stem rather than on the neuromuscular junction or on tht% conductivity of the peripheral nerves makes it different, when observed from a dyna~mits.l aspect, from curare or curare-like drugs. The latter, as it is well known, exhibit anti spasmodic action on the peripheral motor points. Rerger and Bradley, in describing the effect of myanesin on neurological derangements as well as on involuntary movements. based their conclusion on myanesin’s antagonistic: effect on strychnine convulsions autl spasms of tetanus. As these disorders of reflex activity (hyper) of the spinal cord arc abolished by the action of myanesin, they were inclined to believe that the site of act.iou However, Henneman, Kaada, and Kaplan showr*ti of this drug might be the spinal centers. through a long series of experimental work on reflex behavior after the therapeutic dose of myanesin was administered, that the result of its muscle relaxant, antispasmodic character is the continuation of the drug’s depressant action on the facilitatory system or Both of these centers are situated in the suplaexciting action on the inhibitory system. spinal region of the nervous system. These workers, furthermore, are unanimous in their suggestion that the activity of mayanesin is by no means specific toward the nervous reticular substance (medulla oblongata). Its action rather results in the depression of all plurisynaptic systems thanks to their rich provision of internuncial neurons. The duration of its effect as a muscle relaxant, when it is administ.ered within its clinical dose, is limited. This character of the drug may classify its use in clinical therapy as nonessential, ephemeral. Besides this unfortunate nature there are other shortcomings in its use. Then were described quite recently by Pugh, Stephen, and Candy. According to their clinical Riley and Herger observation, myanesin may cause hemoglobinuria and phlebothrombosis. successfully demonstrated a decreased toxicity and prolonged relaxant activity of the tirr~g 1Vood and Schlesinger reported that, when it was combined with acid succinate compound. they were successful in controlling the toxic side effect of the drug as hemoglobinuria stl~l phlebothrombosis, by a 2 per cent solution of m,vanesin mixed with Ringer’s solut.iou. Schwartz and Berger reported unchanged effect of the drug’s activity when it is admirtistered by the oral route. It is obvious that myanesin’s use would find large employment in the treatment of trisms provoked by spastic contraction of the masticatory muscles 01 In his report the author gives stat.isby hyperactive reflexes of the trigeminus nerve. tieal evidence of successful treatments obtained by the use of myanesin in acute iniiltr:itions of the masticatory muscles which were characterized by the involvement, of the The use of antibiotics combined with the administration of regional lymph nodes. myanesin showed a shorter course of the morbidity and gave a favorable result in coutrolling the lesion and completely restoring the health of the patient. The treatment c+f stomatologic disorders in the nature of muscular spasms or hyperactive reflexes possesses a valuable coadjuvant in the application of this muscle relaxant among other mediums of proved efficiency. A. G. N. 671
Literature SURGERY (The Use of Muscle Relaxants 6: 153, May,
in Stomatology.)
1951.
This report on the drugs which are administered in t.he treatment of nourologiczal disorders, such as spasticity, rigidity, and involuntary movements, deals chiefly and PXelusively with the action of myanesin (Mephenesin, Tolserol). First described by Rerger and Bradley in 1946, myanesin when administered in clinical doses (10 to 40 mg./kg.) acts with depressant result on the brain stem (medulla oblongata). This selective action of depression of myanesin on the stem rather than on the neuromuscular junction or on tht% conductivity of the peripheral nerves makes it different, when observed from a dyna~mits.l aspect, from curare or curare-like drugs. The latter, as it is well known, exhibit anti spasmodic action on the peripheral motor points. Rerger and Bradley, in describing the effect of myanesin on neurological derangements as well as on involuntary movements. based their conclusion on myanesin’s antagonistic: effect on strychnine convulsions autl spasms of tetanus. As these disorders of reflex activity (hyper) of the spinal cord arc abolished by the action of myanesin, they were inclined to believe that the site of act.iou However, Henneman, Kaada, and Kaplan showr*ti of this drug might be the spinal centers. through a long series of experimental work on reflex behavior after the therapeutic dose of myanesin was administered, that the result of its muscle relaxant, antispasmodic character is the continuation of the drug’s depressant action on the facilitatory system or Both of these centers are situated in the suplaexciting action on the inhibitory system. spinal region of the nervous system. These workers, furthermore, are unanimous in their suggestion that the activity of mayanesin is by no means specific toward the nervous reticular substance (medulla oblongata). Its action rather results in the depression of all plurisynaptic systems thanks to their rich provision of internuncial neurons. The duration of its effect as a muscle relaxant, when it is administ.ered within its clinical dose, is limited. This character of the drug may classify its use in clinical therapy as nonessential, ephemeral. Besides this unfortunate nature there are other shortcomings in its use. Then were described quite recently by Pugh, Stephen, and Candy. According to their clinical Riley and Herger observation, myanesin may cause hemoglobinuria and phlebothrombosis. successfully demonstrated a decreased toxicity and prolonged relaxant activity of the tirr~g 1Vood and Schlesinger reported that, when it was combined with acid succinate compound. they were successful in controlling the toxic side effect of the drug as hemoglobinuria stl~l phlebothrombosis, by a 2 per cent solution of m,vanesin mixed with Ringer’s solut.iou. Schwartz and Berger reported unchanged effect of the drug’s activity when it is admirtistered by the oral route. It is obvious that myanesin’s use would find large employment in the treatment of trisms provoked by spastic contraction of the masticatory muscles 01 In his report the author gives stat.isby hyperactive reflexes of the trigeminus nerve. tieal evidence of successful treatments obtained by the use of myanesin in acute iniiltr:itions of the masticatory muscles which were characterized by the involvement, of the The use of antibiotics combined with the administration of regional lymph nodes. myanesin showed a shorter course of the morbidity and gave a favorable result in coutrolling the lesion and completely restoring the health of the patient. The treatment c+f stomatologic disorders in the nature of muscular spasms or hyperactive reflexes possesses a valuable coadjuvant in the application of this muscle relaxant among other mediums of proved efficiency. A. G. N. 671