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Precurarization with Vecuronium and Pancuronium in Awake, Healthy Volunteers: The Influence on Neuromuscular Transmission and Pulmonary Function
Author(s) -
ENGBÆK J.,
HOWARDYHANSEN P.,
ØRDING H.,
VIBYMOGENSEN J.
Publication year - 1985
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1985.tb02170.x
Subject(s) - medicine , neuromuscular transmission , pancuronium bromide , anesthesia , vecuronium bromide , neuromuscular blockade , neuromuscular monitoring
The influence of pretreatment with pancuronium and vecuronium on the neuromuscular transmission was compared in 24 healthy, awake, non‐premedicated volunteers using train‐of‐four (TOF) nerve stimulation and measurement of respiratory frequency, vital capacity, inspiratory force and peak expiratory flow (PEF). The subjects were randomly allocated to one of three groups. Each subject received one dose of pancuronium and one dose of vecuronium: Group I pancuronium 0.01 mg/kg and vecuronium 0.005 mg/kg; Group II pancuronium 0.01 mg/kg and vecuronium 0.01 mg/kg and Group III pancuronium 0.01 mg/kg and vecuronium 0.015 mg/kg intravenously. The median TOF ratio decreased significantly in Groups I and II following both pancuronium and vecuronium. The TOF ratio following vecuronium in Group II was significantly lower compared to the TOF ratio following vecuronium in Group I. Only PEF decreased significantly in Group I following pancuronium and in Group II following both pancuronium and vecuronium. There was no significant difference between Group I and Group II regarding the number of subjects with signs or symptoms of partial neuromuscular blockade. Following vecuronium 0.005 mg/kg, one subject was unable to swallow and the twitch height decreased to 0.25. In Group II one subject was unable to lift her head and had difficulty in swallowing following pancuronium 0.01 mg/kg. Only four subjects entered Group III because of an unacceptably high frequency of signs and symptoms of partial neuromuscular blockade and a decrease in median TOF ratio to 0.64 following vecuronium. The subjects felt it difficult to swallow, and one subject could just sustain head lift for 10 s following vecuronium 0.015 mg/kg. It is concluded that vecuronium in dose levels up to 0.01 mg/kg only causes minor changes in neuromuscular transmission and pulmonary function. Increasing the dose of vecuronium to 0.015 mg/kg is followed by an unacceptably high frequency of signs and symptoms of partial neuromuscular blockade.