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JAMA. 1954;155(9):852. doi:10.1001/jama.1954.03690270048020.
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ABSTRACT

Hexymethylene Biscarbaminoylcholine.  —At the meeting of the Society of Physicians in Vienna on Jan. 15, 1954, Dr. H. Brücke reported on the practical use of polymethylene biscarbaminoylcholine in surgery. Hexamethylene biscarbaminoylcholine was given a therapeutic trial in 178 patients. The new preparation proved to be three times as effective as curare and, thus, represents the strongest known skeletal muscle relaxant. Since it is not destroyed in the body but is excreted by the kidneys, the dose-effect curve rises abruptly when the drug is administered in large doses. The critical dosage is about 0.12 to 0.15 mg. per kilogram of body weight. This should be exceeded only if an operation of three or four hours' duration is anticipated. In other cases, it seems advisable to give, from the first, a single dose that should be determined according to body weight and expected duration of the operation. The drug may be combined

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