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Spontaneous recovery of residual neuromuscular blockade after atracurium or vecuronium during isoflurane anaesthesia
Author(s) -
Erkola O.,
Karhunen U.,
SandelinHellqvist E.
Publication year - 1989
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.1399-6576.1989.tb02910.x
Subject(s) - neuromuscular blockade , isoflurane , medicine , anesthesia , spontaneous recovery , neuromuscular monitoring , atracurium besilate , blockade , vecuronium bromide , muscle relaxant , neuromuscular transmission , receptor
With atracurium and vecuronium, spontaneous recovery of residual neuromuscular blockade monitored electromyographically during 0.5% isoflurane anaesthesia was studied in 60 patients undergoing plastic surgery. After thiopentone, in random order, either atracurium 0.5 mg kg ‐1 or vecuronium 0.1 mg kg ‐1 was administered and isoflurane added to N 2 O and O 2 mixture. Following spontaneous recovery of both the single twitch amplitude (T 1 ) to 75% of the control value and the train‐of‐four ratio (TOF ratio) to 75%, incremental doses of the relaxant were given to maintain the T 1 at less than 10%. Before the end of surgery, the blockade was again permitted to recover spontaneously. During the initial spontaneous recovery, the mean recovery time of T 1 from 25% to 75% (the recovery index) with atracurium was longer ( P <0.001) than that with vecuronium (13.2 min and 10.1 min, respectively) but, during the second recovery, the mean recovery index was shorter ( P <0.05) with atracurium than with vecuronium (16.1 min and 19.8 min, respectively). The recovery time from T 1 75% to TOF ratio 75%, indicating the recovery rate of residual neuromuscular blockade, with atracurium was about 15 min after both the initial and the second recoveries. With vecuronium, the respective recovery times were significantly ( P <0.001) longer (25.6 min and 38.5 min, respectively). It is concluded that with vecuronium there is slower spontaneous recovery of residual neuromuscular blockade than with atracurium.