High concentration sevoflurane induction of anesthesia accelerates onset of vecuronium neuromuscular blockade.
OBJECTIVE
To investigate neuromuscular block using accelography after administration of vecuronium under sevoflurane 8% induction and maintenance with sevoflurane 2% in adults.


METHODS
Patients were allocated to three groups: (1) group I: anesthesia was induced and maintained with propofol and fentanyl (n= 15), (2) group II: anesthesia was induced with propofol and maintained with N2O(66%)-O2-sevoflurane 2% (n = 15), (3) group III: anesthesia was induced with sevoflurane 8% using a vital capacity inhalation induction and maintained with N2O(66%)-O2-sevoflurane 2% (n = 15). 0.1 mg x kg(-1) vecuronium was used for paralysis three minutes after anesthetic induction and reversed using intravenous 0.04 mg x kg(-1) neostigmine with 0.02 mg kg atropine when the train-of-four (TOF) ratio returned to 25%.


RESULTS
The onset time from initial administration of vecuronium to maximal block in the group III was shorter than that in the groups I and II (139 +/- 35, 193 +/- 35 and 188 +/- 47s, respectively: P < 0.05). The clinical duration from maximal block to 25% recovery of TOF ratio in group II and III was longer than that in the group I (47 +/- 15, 48 +/- 14 and 36 +/- 10 min, respectively: P < 0.05). The reversal times from administration of neostigmine to 75% of TOF ratio in groups II and III were longer than that in the group I (196 +/- 53, 208 +/- 64 and 136 +/- 28s, respectively: P < 0.05).


CONCLUSIONS
Vital capacity inhalation induction of anesthesia with sevoflurane accelerates onset and prolongs duration of vecuronium neuromuscular block compared with propofol-fentanyl anesthesia.
Yamaguchi
S
S
Department of Anesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan. sigeki@peach.ocn.ne.jp
Egawa
H
H
Okuda
K
K
Mishio
M
M
Okuda
Y
Y
Kitajima
T
T
D000759:Adjuvants, Anesthesia; D000328:Adult; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D004558:Electric Stimulation; D005260:Female; D005283:Fentanyl; D006801:Humans; D007702:Kinetocardiography; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents; D015742:Propofol; D000077149:Sevoflurane; D014673:Vecuronium Bromide
D000759:Adjuvants, Anesthesia; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D000077149:Sevoflurane; D014673:Vecuronium Bromide; D005283:Fentanyl; D015742:Propofol