Gabexate mesilate hastens recovery from vecuronium-induced neuromuscular blockade.
OBJECTIVE
To test the hypothesis that gabexate mesilate, a protease inihibitor, hastens recovery from neuromuscular blockade, we examined the effect of gabexate mesilate on the recovery of vecuronium-induced neuromuscular blockade in anaesthetized patients in a double-blind, randomized fashion.


METHODS
Thirty adult patients were divided into two groups of 15. In the gabexate mesilate group, immediately after administration of vecuronium 0.1 mg kg(-1), a continuous infusion of gabexate mesilate was started at a speed of 1.5 mg kg(-1) h(-1). In the control group, normal saline was administered instead of gabexate mesilate. Times to the return of T1, T2, T3 or T4 (first, second, third and fourth response of train-of-four (TOF)), times to the recovery of T1/control to 0.25 (T25) or 0.5 (T50), recovery of T1/control or TOF ratio (T4/T1) were compared between the two groups.


RESULTS
Times to the returns of T1, T2, T3 and T4 in the gabexate mesilate group were significantly shorter than in the control group (19.4 +/- 6.8 vs. 25.7 +/- 7.2 min for T1; mean +/- SD, P = 0.020). Times to T25 and T50 were significantly shorter in the gabexate mesilate group than in the control group (34.0 +/- 9.9 vs. 51.3 +/- 10.2 min for T25, P < 0.001). T1/control and TOF ratio in the gabexate mesilate group were significantly higher than in the control group 40-80 min and 40-120 min after administration of vecuronium, respectively (P < 0.05).


CONCLUSIONS
Gabexate mesilate hastens recovery from neuromuscular block in anaesthetized patients receiving vecuronium.
Hattori
H
H
Fukushima Medical University School of Medicine, Department of Anesthesiology, Fukushima City, Fukushima, Japan. hattori@sb.dcns.ne.jp
Saitoh
Y
Y
Nakajima
H
H
Sanbe
N
N
Akatu
M
M
Murakawa
M
M
D000328:Adult; D000368:Aged; D000758:Anesthesia; D000762:Anesthesia Recovery Period; D004558:Electric Stimulation; D005260:Female; D016670:Gabexate / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents; D011229:Preanesthetic Medication; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology*; D014673:Vecuronium Bromide
D003473:Neuromuscular Nondepolarizing Agents; D015842:Serine Proteinase Inhibitors; D016670:Gabexate; D014673:Vecuronium Bromide