Does pancuronium or cisatracurium delay the rate of arousal following remifentanil-based anesthesia?
OBJECTIVE
The present report investigates the rate of arousal following remifentanil-based anesthesia associated with the coadministration of pancuronium, which inhibits butyrylcholinesterase, or cisatracurium, which is partially metabolized by nonspecific esterases, versus vecuronium that is eliminated independently of ester hydrolysis.


METHODS
Sixty patients, ASA I-II, scheduled for elective abdominal surgeries were enrolled in a double-blinded prospective study. In fact, patients were equally divided into three Groups with each Group receiving remifentanil and either one of the following three muscle relaxants: pancuronium, vecuronium or cisatracurium.


METHODS
The rate of arousal following discontinuation of anesthesia was assessed by Modified Aldrete Score. Time to eye opening on verbal command, tracheal extubation, Modified Aldrete Score >9, and time to discharge from the recovery room were recorded.


RESULTS
Time to eye opening on verbal command, tracheal extubation, Modified Aldrete Score >9, and time to discharge from the recovery room were not significantly different between the three groups.


CONCLUSIONS
The results suggest that recovery following remifentanil-based anesthesia is not delayed by the coadministration of pancuronium, cisatracurium versus vecuronium; and by the use of neostigmine for reversal of neuromuscular blockade.
Baraka
Anis S
AS
Department of Anesthesiology, American University of Beirut-Medical Center, Beirut-Lebanon. abaraka@aub.edu.lb
Haroun-Bizri
Sania T
ST
Nawfal
Maud F
MF
Gerges
Frederic J
FJ
Nasr
Viviane G
VG
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000762:Anesthesia Recovery Period; D018686:Anesthetics, Intravenous; D001279:Atracurium / Q000031:analogs & derivatives* / Q000494:pharmacology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology*; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D010197:Pancuronium / Q000494:pharmacology*; D010880:Piperidines; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D009466:Neuromuscular Blocking Agents; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D001279:Atracurium; D010197:Pancuronium; D000077208:Remifentanil; C101584:cisatracurium