Resistance to vecuronium.
A 19-year-old epileptic patient taking carbamazepine was anaesthetised for a sigmoid colectomy. Such patients are reported to show a resistance to the actions of competitive neuromuscular blocking drugs, and a conventional dose of vecuronium (0.1 mg.kg-1) produced relaxation for only 18 min. Subsequently she received vecuronium 6.7 mg.h-1 which kept the first twitch of the train-of-four response at 30% of the control value. Antagonism with neostigmine 1.25 mg produced a rapid and full recovery. The report illustrates the usefulness of monitoring neuromuscular transmission whenever there is an anticipation of an altered response.
Norman
J
J
Shackleton Department of Anaesthetics, General Hospital, Southampton.
D000328:Adult; D002220:Carbamazepine / Q000627:therapeutic use; D004351:Drug Resistance; D004569:Electroencephalography; D004827:Epilepsy / Q000517:prevention & control; D005260:Female; D006801:Humans; D009388:Neostigmine / Q000494:pharmacology; D014673:Vecuronium Bromide / Q000037:antagonists & inhibitors / Q000494:pharmacology*
D002220:Carbamazepine; D009388:Neostigmine; D014673:Vecuronium Bromide