A comparison between vecuronium and atracurium in myasthenia gravis.
We evaluated the effect of vecuronium bromide and atracurium besylate on the train-of-four response in the management of muscle relaxation in 20 patients with myasthenia gravis (MG) who were undergoing thymectomy. We confirmed the safe use of these two non-depolarizing muscle relaxants in MG patients. Vecuronium (0.04 mg.kg-1) demonstrated a lesser clinical duration than did atracurium (0.2 mg.kg-1) (38 +/- 19 vs 50 +/- 21 min, mean +/- s.e.mean). The recovery time for vecuronium patients was shorter than that for atracurium patients (22 +/- 18 vs 38 +/- 18 min), but the time until onset of neuromuscular blockade was longer with vecuronium (246 +/- 105 vs 107 +/- 103 s). During spontaneous recovery from neuromuscular relaxation, at T1/C of 25% and 100%, the train-of-four fade with vecuronium was significantly greater than that with atracurium (0.04 +/- 0.02, 0.16 +/- 0.03 vs 0.17 +/- 0.01, 0.83 +/- 0.03), suggesting that vecuronium had a greater prejunctional effect than did atracurium.
Chan
K H
KH
Department of Anaesthesiology, Veterans General Hospital, Taipei, Taiwan, ROC.
Yang
M W
MW
Huang
M H
MH
Hseu
S S
SS
Chang
C C
CC
Lee
T Y
TY
Lin
C Y
CY
D000328:Adult; D001279:Atracurium / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000601:surgery*; D009469:Neuromuscular Junction / Q000187:drug effects*; D013934:Thymectomy; D014673:Vecuronium Bromide / Q000494:pharmacology*
D001279:Atracurium; D014673:Vecuronium Bromide