title: Onset of neuromuscular block during total intravenous anaesthesia: effects of ketamine compared with alfentanil.
abstract: Anaesthesia was induced in 30 ASA I patients by propofol titrated at 100 mg min-1 to loss of verbal contact, and maintained by infusion of propofol at 10 mg kg-1 h-1 with 100% oxygen. According to randomization, either alfentanil 30 micrograms kg-1 ketamine 1.5 mg kg-1, or 0.9% sodium chloride was injected over 20 s, followed 1 min later by vecuronium 0.08 mg kg-1. Mean arterial pressure and heart rate were measured before and after induction, and 1 and 2 min after analgesic or saline. Onset of neuromuscular block was measured by the evoked hypothenar electromyographic response to train-of-four supra-maximal stimuli at 0.1 Hz. There were significant haemodynamic differences between groups, but mean (SD) times to reduction of T1/control ratios below 95% were 114 (28.0), 106 (19.0) and 128 (34.3) s (P = 0.2, ANOVA). Supplementation of propofol anaesthesia with alfentanil or ketamine does not appear to influence the onset time of vecuronium.
authors.affiliation: Department of Surgical and Anaesthesic Sciences, University of Sheffield, Royal Hallamshire Hospital, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Levy
authors.forename: J E
authors.initials: JE
authors.lastname: Peacock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015760:Alfentanil / Q000494:pharmacology; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D004576:Electromyography; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007649:Ketamine / Q000494:pharmacology; D008875:Middle Aged; D009469:Neuromuscular Junction / Q000187:drug effects*; D013997:Time Factors; D014673:Vecuronium Bromide / Q000494:pharmacology
chemical_list: D015760:Alfentanil; D007649:Ketamine; D014673:Vecuronium Bromide