Abstract
To the Editor: —This letter is in reference to the case report submitted by Dr. H. Zimmerman in the June 30, 1951 issue ofThe Journal. This case of prolonged postoperative respiratory paralysis and death followed the administration of d-tubocurarine and syncurine® (decamethylene-1,10-bistrimethylammoniumdibromide) during ether anesthesia. The editorial heading of this report is entitled Death Following Curare Administration. On the basis of information submitted, it seems unlikely that d -tubocurarine is the cause of prolonged respiratory paralysis. In this instance d -tubocurarine and syncurine® have been loosely and inaccurately lumped together in the title. Several points should be mentioned to prevent confusion and misconception in the minds of readers. While both agents produce myoneural block and motor paralysis, d -tubocurarine acts in a distinctly different pharmacological manner than does syncurine.® Decamethonium (syncurine) and d -tubocurarine cause neuromuscular block by fundamentally different mechanisms. Block by decamethonium is due to a persistent
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