Pretreatment dose of vecuronium and its effect on succinylcholine-induced fasciculations and neuromuscular blockade
Kinouchi, K.; Tashiro, C.; Mori, T.; Nishimura, M.; Fukumitsu, K.; Tomi, K.; Takenoshita, M.; Yoshiya, I.
Masui. Japanese Journal of Anesthesiology 36(1): 77-81
1987
ISSN/ISBN: 0021-4892 PMID: 2882036 Document Number: 300430
The effect of vecuronium on succinylcholine (SCC)-induced neuromuscular blockade as well as the dose required to prevent fasciculations were studied. Sixty-eight patients (ASA I-II) were allocated randomly to six groups according to the type and dosage of pretreatment, as follows; Group 1: no pretreatment (control), Group 2: d-tubocuranine (dTc) 60 mcg/kg, Group 3: pancuronium 20 mcg/kg, Group 4: vecuronium (VEC) 10 mcg/kg, Group 5: VEC 15 mcg/kg and Group 6: VEC 20 mcg/kg. After induction of anesthesia, train of four stimuli were applied on the ulnar nerve at the wrist every 20 seconds. After twitches became constant, the pretreatment were given and three minutes later, SCC 1 mg/kg was injected. When a twitch height was depressed to 10% of control, the trachea was intubated. SCC-induced fasciculations were effectively suppressed with dTc, pancuronium and 20 mcg/kg of VEC. Intubation conditions were not different among the groups. The onset time of SCC was prolonged in all pretreated groups. DTc and all doses of VEC shortened the duration of SCC-induced neuromuscular blockade, while pancuronium did not. In conclusion, VEC 20 mcg/kg can be used to prevent SCC-induced fasciculations in place of dTc 60 mcg/kg or pancuronium 20 mcg/kg.