[Influence of epidural lidocaine injection on vecuronium-induced neuromuscular blockade].
BACKGROUND
We investigated vecuronium-induced neuromuscular blockade in patients with continuous epidural lidocaine injection and those without epidural lidocaine.


METHODS
Lower thoracic epidural injection of lidocaine was commenced at a rate of 2-3 mg x kg(-1) x h(-1) following its bolus injection (1.5-2 mg x kg(-1)) only in epidural group. Neuromuscular function was monitored by acceleromyographic train-of-four (TOF) responses of the adductor pollicis muscle to ulnar nerve stimulation after induction of general anesthesia.


RESULTS
Neuromuscular block was obtained by vecuronium 0.1 mg x kg(-1) as an intubating dose and was maintained 5-10% of baseline first twitch (T 1) of TOF responses by continuous vecuronium administration. The maximum depression of T 1 response and onset time obtained by vecuronium 0.1 mg x kg(-1) were not different between the groups, but mean clinical duration from administration of the first dose to T 1 recovery to 5% of baseline was significantly prolonged in group with epidural lidocaine (49.5 min), compared to that without lidocaine (32.3 min). Furthermore, maintenance dose of vecuronium obtained in the group with epidural lidocaine (0.034 mg x kg(-1) x h(-1)) was significantly smaller than that in the group without lidocaine (0.060 mg x kg(-1) x h(-1)).


CONCLUSIONS
Based on our results, we conclude that lidocaine injected continuously into the epidural space potentiates vecuronium-induced neuromuscular block.
Munakata
Kazuhiko
K
Department of Anesthesiology, Nihon University School of Medicine, Tokyo 173-0032.
Suzuki
Takahiro
T
Watanabe
Naoto
N
Nagai
Hitoshi
H
Kakishita
Michiko
M
Saeki
Shigeru
S
Ogawa
Setsurou
S
D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000494:pharmacology; D004357:Drug Synergism; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D008012:Lidocaine / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology* / Q000627:therapeutic use; D014673:Vecuronium Bromide / Q000494:pharmacology* / Q000627:therapeutic use
D000779:Anesthetics, Local; D003473:Neuromuscular Nondepolarizing Agents; D014673:Vecuronium Bromide; D008012:Lidocaine