Increased sensitivity to vecuronium and prolonged duration of its action in patients with end-stage renal failure.
J Clin Anesth
; 13(3): 193-7, 2001 May.
Article
em En
| MEDLINE
| ID: mdl-11377157
ABSTRACT
STUDY OBJECTIVES:
To determine whether the duration of action of vecuronium is influenced by chronic renal failure.DESIGN:
Prospective clinical comparison.SETTING:
Operating room, Hokkaido University Hospital. PATIENTS 7 adult ASA physical status II and III patients with impaired renal function undergoing living-related renal transplantation (Group A), 5 adult ASA physical status II and III patients with impaired renal function undergoing elective surgery other than renal transplantation (Group B), and 13 adult ASA physical status I and II patients with normal hepatorenal function undergoing elective surgery (Group C).INTERVENTIONS:
Anesthesia was induced with thiamylal 5 mg x kg(-1) and fentanyl 100 microg IV and maintained with 60% nitrous oxide and 1% isoflurane. An initial dose of vecuronium was administered and patients' tracheas were intubated. MEASUREMENTS Neuromuscular function was monitored by acceleration of thumb adduction with train-of-four stimulation. Vecuronium 60 microg x kg(-1) was administered as the initial dose via a central catheter, and if the first twitch was more than 3% of the control, another dose of vecuronium 20 microg x kg(-1) was given as necessary. Both onset time and duration of action until 25% recovery were measured. Plasma vecuronium and its metabolite, 3-desacetyl-vecuronium, levels were measured at onset and at 25% recovery in Groups A and C. MAINRESULTS:
The total dose of vecuronium and initial concentration of vecuronium showed no significant difference between Group A and Group C. Duration of action was significantly prolonged in Group A and Group B compared with Group C.CONCLUSIONS:
Duration of action of vecuronium is prolonged in patients with end-stage renal failure mainly due to higher sensitivity to vecuronium.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Brometo de Vecurônio
/
Fármacos Neuromusculares não Despolarizantes
/
Anestesia
/
Falência Renal Crônica
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Anesth
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Japão