Assessment of neuromuscular and haemodynamic effects of cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia in elderly patients.
OBJECTIVE
Neuromuscular block times, quality of muscle relaxation for tracheal tube insertion, and the haemodynamic effects after cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia were compared in elderly patients.


METHODS
The study was performed in 40 patients over 65 yr of age. Anaesthesia was induced with thiopental, and maintained with sevoflurane in N2O/O2 and remifentanil. Cisatracurium 0.15 mg kg(-1) or vecuronium 0.1 mg kg(-1) were administered after induction. Intubation was attempted when neuromuscular block was 95%. Onset time, clinical duration of action, recovery index, spontaneous recovery time and tracheal intubation conditions were assessed. Haemodynamic parameters were also monitored.


RESULTS
The average ages of the patients were 72.5 +/- 5.1 and 73.6 +/- 6.3 in the cisatracurium and vecuronium groups, respectively. Onset time was significantly shorter after vecuronium, 158 +/- 34 s vs. 200 +/- 50s, respectively. Recovery index was significantly shorter after cisatracurium, 19.5 +/- 7.5 s vs. 33.7 +/- 18.6 s (P < 0.05). Clinical duration and spontaneous recovery time were similar in both groups as well as haemodynamic variables.


CONCLUSIONS
In elderly patients, vecuronium has a faster onset time while cisatracurium has a shorter recovery index under sevoflurane-remifentanil anaesthesia.
Keleş
G T
GT
Department of Anaesthesiology and Reanimation, Faculty of Medicine, University of Celal Bayar, Manisa, Turkey. gonul.keles@bayar.edu.tr
Yentür
A
A
Cavuş
Z
Z
Sakarya
M
M
D000368:Aged; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D001279:Atracurium / Q000031:analogs & derivatives* / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D008297:Male; D008738:Methyl Ethers / Q000627:therapeutic use*; D009126:Muscle Relaxation / Q000187:drug effects*; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D010880:Piperidines / Q000627:therapeutic use*; D000077208:Remifentanil; D000077149:Sevoflurane; D013997:Time Factors; D014673:Vecuronium Bromide / Q000494:pharmacology*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D009466:Neuromuscular Blocking Agents; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D001279:Atracurium; D000077149:Sevoflurane; D014673:Vecuronium Bromide; D000077208:Remifentanil; C101584:cisatracurium