Does vecuronium accumulate in the renal transplant patient?
Twenty ASA physical status Class III patients undergoing cadaver renal transplantation were studied. After 90 per cent T1 recovery, as determined by train-of-four measurement, from 1.0 mg.kg-1 succinylcholine to facilitate tracheal intubation, nine patients received atracurium 0.25 mg.kg-1 (Group I) and 11 patients received vecuronium 0.05 mg.kg-1 (Group II) intravenously. The following measurements were made: time to maximum block onset (first dose Max), injection to start of recovery (start REC1), injection to 25 per cent T1 twitch recovery (REC 251), injection to 75 per cent T1 (REC 75(1], injection to 90 per cent T1 (REC 90(1] and time from 25-75 per cent recovery T1 (REC 25-75(1]. Maximum blockade (Max block 1) was also measured. At 90 per cent T1 recovery, if time permitted, an identical dose of the appropriate relaxant was administered. Time from second dose to onset of maximum block (second dose Max) and 90 per cent recovery after second dose (REC 90(2] were then measured. At the conclusion of surgery, neuromuscular blockade was reversed with neostigmine 2.5 mg and glycopyrrolate 0.5 mg. One way ANOVA was performed to determine significance between the groups and a p less than 0.05 was considered significant. A paired t test was also performed between REC 90(1) and REC 90(2) for atracurium and vecuronium respectively. A p less than 0.05 was again considered significant. Measurement of first dose Max, start REC1, REC25(1), REC 75(1), REC 90(1), REC 25-75(1) and Max block 1 revealed no difference between the patients receiving an initial dose of atracurium and those receiving vecuronium.(ABSTRACT TRUNCATED AT 250 WORDS)
Starsnic
M A
MA
Thomas Jefferson University Hospital, Department of Anesthesiology, Philadelphia, Pennsylvania 19107.
Goldberg
M E
ME
Ritter
D E
DE
Marr
A T
AT
Sosis
M
M
Larijani
G E
GE
D000328:Adult; D001279:Atracurium / Q000494:pharmacology*; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D009469:Neuromuscular Junction / Q000187:drug effects*; D014673:Vecuronium Bromide / Q000493:pharmacokinetics / Q000494:pharmacology*
D001279:Atracurium; D014673:Vecuronium Bromide