Nicorandil accelerates recovery of neuromuscular block caused by vecuronium.
OBJECTIVE
To examine the effect of nicorandil, a K ATP channel agonist, on neuromuscular block caused by vecuronium in patients anesthetized with nitrous oxide, oxygen, isoflurane, and fentanyl.


METHODS
Sixty adult patients were allocated to four groups of 15: nicorandil-post-tetanic count (N-PTC), nicorandil-train-of-four (N-TOF), control-post-tetanic count (C-PTC) or control-train-of-four (C-TOF) group. In the N-PTC and N-TOF groups, 0.1 mg kg nicorandil was given as a bolus followed by an infusion at 1 microg x kg(-1) x min(-1). Two minutes after the bolus, 0.1 mg x kg(-1) vecuronium was administered. In the C-PTC or C-TOF group normal saline was given instead of nicorandil. PTC and TOF responses were measured mechanically using a force displacement transducer.


RESULTS
Time from the administration of vecuronium to the onset of neuromuscular block in the N-PTC or N-TOF group did not differ from that in the C-PTC or C-TOF group (241 +/- 33 vs 225 +/- 32 sec, mean +/- SD). Times from vecuronium injection to the return of PTC in the N-PTC and C-PTC groups, and those of T1, T2, T3, and T4 (first, second, third, and fourth stimulation of TOF) in the N-TOF and C-TOF groups did not differ. Recoveries of PTC in the N-PTC and C-PTC groups followed similar time course. T1/control twitch height and TOF ratio (T4/T1) in the N-TOF group were higher than those in the C-TOF group 80-120 min and 100-120 min after administration of vecuronium, respectively.


CONCLUSIONS
Nicorandil accelerates recovery of neuromuscular block caused by vecuronium.
Saitoh
Y
Y
Department of Anesthesiology, Fukushima Medical University School of Medicine, Japan. ys@m6.people.or.jp
Kaneda
K
K
Fujii
Y
Y
Oshima
T
T
D000769:Anesthesia, Inhalation; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents; D020108:Nicorandil / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014673:Vecuronium Bromide
D003473:Neuromuscular Nondepolarizing Agents; D014665:Vasodilator Agents; D020108:Nicorandil; D014673:Vecuronium Bromide