Assessment of neuromuscular and haemodynamic effects of cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia in elderly patients
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2004
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Abstract
Background and objective: Neuromuscular block times, quality of muscle relaxation for tracheal tube insertion, and the haemodynamic effects after cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia were compared in elderly patients. Methods: The study was performed in 40 patients over 65 yr of age. Anaesthesia was induced with thiopental, and maintained with sevoflurane in N2O/O2 and remifentanil. Cisatracurium 0.15 mg kg-1 or vecuronium 0.1 mg kg-1 were administered after induction. Intubation was attempted when neuromuscular block was 95%. Onset time, clinical duration of action, recovery index, spontaneous recovery time and tracheal intubation conditions were assessed. Haemodynamic parameters were also monitored. Results: The average ages of the patients were 72.5 ± 5.1 and 73.6 ± 6.3 in the cisatracurium and vecuronium groups, respectively. Onset time was significantly shorter after vecuronium, 158 ± 34s vs. 200 ± 50s, respectively. Recovery index was significantly shorter after cisatracurium, 19.5 ± 7.5s vs. 33.7 ± 18.6s (P < 0.05). Clinical duration and spontaneous recovery time were similar in both groups as well as haemodynamic variables. Conclusions: In elderly patients, vecuronium has a faster onset time while cisatracurium has a shorter recovery index under sevoflurane-remifentanil anaesthesia.
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Aged , Anesthesia Recovery Period , Anesthetics, Inhalation , Anesthetics, Intravenous , Atracurium , Blood Pressure , Double-Blind Method , Female , Heart Rate , Hemodynamic Processes , Humans , Intubation, Intratracheal , Male , Methyl Ethers , Muscle Relaxation , Neuromuscular Blocking Agents , Neuromuscular Nondepolarizing Agents , Piperidines , Time Factors , Vecuronium Bromide , cisatracurium , nitrous oxide , oxygen , remifentanil , sevoflurane , thiopental , vecuronium , aged , aging , anesthesia induction , article , clinical article , clinical trial , controlled clinical trial , controlled study , disease course , double blind procedure , endotracheal intubation , general anesthesia , hemodynamic monitoring , hemodynamic parameters , hemodynamics , human , muscle relaxation , neuromuscular blocking , randomized controlled trial