Delayed recovery of vecuronium neuromuscular block in diabetic patients during sevoflurane anesthesia.
OBJECTIVE
To study recovery from vecuronium-induced neuromuscular block in diabetic patients during total iv or sevoflurane anesthesia.


METHODS
30 diabetic patients were assigned to diabetes mellitus (DM)-total iv anesthesia (TIVA); (n = 15) or DM-sevoflurane (S) groups (n = 15). Thirty healthy patients were divided into control-TIVA (n = 15) or control-S groups (n = 15). In the DM-TIVA or control-TIVA groups and DM-S or control-S groups, anesthesia was maintained with propofol and fentanyl, and nitrous oxide-oxygen-sevoflurane 1.7%, respectively. After receiving vecuronium 0.1 mg.kg(-1)iv, recovery of the train-of-four (TOF) was compared among the four groups.


RESULTS
Times to the return of T2, T3, or T4 in the DM-TIVA and DM-S groups were longer than in the control-TIVA and control-S groups (46.9 +/- 13.8 vs 32.2 +/- 10.7 and 32.6 +/- 8.7 min for T2, P < 0.05). T1/control in the DM-S group was less than in the control-TIVA and DM-TIVA groups 50 to 120 and 70 to 120 min after receiving vecuronium, respectively (P < 0.05). T1/control in the control-S group was less than in the control-TIVA group 80 to 120 min after receiving vecuronium (P < 0.05). TOF ratio in the DM-S group was less than in the control-TIVA, DM-TIVA, and control-S groups, 60 to 120, 80 to 120, and 80 to 120 min after receiving vecuronium, respectively (P < 0.05).


CONCLUSIONS
In diabetic patients receiving vecuronium, recovery of T1/control and TOF ratio are delayed during sevoflurane anesthesia, but not in association with total iv anesthesia.
Saitoh
Yuhji
Y
Department of Anesthesiology, Saitama Medical School, 38, Morohongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan. ysys@r5.dion.ne.jp
Hattori
Hisashi
H
Sanbe
Norie
N
Nakajima
Hiroshi
H
Akatu
Masahiko
M
Murakawa
Masahiro
M
D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D000077149:Sevoflurane; D013997:Time Factors; D014673:Vecuronium Bromide / Q000494:pharmacology*
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D000077149:Sevoflurane; D014673:Vecuronium Bromide