[Clinical study of vecuronium maintenance speed in trigeminal microvascular decompression surgery].
BACKGROUND
Patients receiving chronic carbamazepine therapy may be resistant to vecuronium. The purpose of this study was to determine maintenance speed of vecuronium in trigeminal microvascular decompression surgery.


METHODS
The vecuronium maintenance speed of the patient for microvascular decompression diagnosed as trigeminal neuralgia (group T: n=18) or hemi-facial spasm (group C: n=18) was examined retrospectively. Anesthesia was induced with propofol, ketamine, midazolam and buprenorphine. Vecuronium was given to facilitate tracheal intubation. The patients received balanced anesthesia with infusion of propofol, ketamine, buprenorphine and vecuronium (60-80 microg x kg(-1) x h(-1)), with nitrous oxide. In both groups the scheduled vecuronium maintenance speed was increased if needed, using the TOF-Watch, at the time of body movement or with more than four TOF count.


RESULTS
All patients of group T were medicated with carbamazepine before operation. None of C received carbamazepine. With C, vecuronium maintenance speed was as scheduled. With T, however, scheduled vecuronium speed increased in most of the cases. Actual vecuronium speed was significantly faster with T, compared with C. Although actual speed divided by scheduled speed was 1 in group C, it was 1.4 in T.


CONCLUSIONS
Vecuronium maintenance speed is 1.4 times of scheduled speed in patients medicated with carbamazepine.
Onaka
Masahiko
M
Department of Anesthesia, Shiroyama Hospital, Habikino.
Yamamoto
Hiromitsu
H
D000368:Aged; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents; D012189:Retrospective Studies; D014277:Trigeminal Neuralgia / Q000601:surgery*; D014673:Vecuronium Bromide
D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D014673:Vecuronium Bromide