[The effect of anesthetic technique on recovery from neuromuscular blockade with cisatracurium].
OBJECTIVE
To assess the effect of four anesthetic techniques on recovery after a single dose of 0.2 mg/kg of cisatracurium.


METHODS
After giving informed consent, 96 patients of both sexes, ASA I-III, were enrolled. Anesthesia was induced with fentanyl, propofol O2-N2O (FiO2 40%) after which the patients were randomly assigned to four groups according to maintenance technique: propofol by infusion, sevoflurane, desflurane or isoflurane at 1.3 MAC. Neuromuscular block was monitored (electromyographic recording of the pollicis adductor). Variables recorded were time of maximum block, duration of action of 1% and 25%, and recovery indices at T0-TR75 andT25%-T75%. ANOVA was performed ( = 0.05 and beta = 0.1).


RESULTS
The groups were homogeneous. Time until recovery of 25% of baseline amplitude of the first response to a train of four (TOF) (T1) was longer in the desflurane group (68.4 +/- 11.1 min) than in the propofol group (60.2 +/- 9.4 min; p < 0.05). Time until recovery of 75% of the TOF-ratio was longer in the sevoflurane (96.8 +/- 13.1 min), desflurane (101.5 +/- 14.4 min) and isoflurane (94.1 +/- 13.9 min) groups than in the propofol group (83.7 +/- 1.3 min) (p < 0.0001). Times until recovery of T1 up to 1% were not statistically different: 45.8 +/- 10.7 (propofol), 50.6 +/- 11.0 (sevoflurane), 51.3 +/- 11.5 (desflurane) and 46.5 +/- 11.2 min (isoflurane). The 25% - 75% recovery index was also similar at 19.0 +/- 9.3 (propofol), 20.0 +/- 5.1 (sevoflurane), 25.7 +/- 12.4 (desflurane) and 20.9 +/- 7.9 (isoflurane).


CONCLUSIONS
The inhaled anesthetics studied prolong the duration of clinical effect of cisatracurium more than does propofol.
Ortiz Gómez
J
J
Departamento de Anestesiología y Cuidados Intensivos. Clínica Universitaria. Facultad de Medicina, Pamplona. jortzig@unav.es
Percaz Bados
J
J
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000493:pharmacokinetics*; D001279:Atracurium / Q000008:administration & dosage* / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D000077335:Desflurane; D004347:Drug Interactions; D004576:Electromyography; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology; D008875:Middle Aged; D019148:Neuromuscular Blockade; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D015742:Propofol / Q000494:pharmacology; D011446:Prospective Studies; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D009466:Neuromuscular Blocking Agents; D001279:Atracurium; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane; C101584:cisatracurium; D015742:Propofol