Assessment of neuromuscular and haemodynamic effects of cisatracurium and vecuronium under sevoflurane-remifentanil anaesthesia in elderly patients
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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/O-2 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 +/- 34 s vs. 200 +/- 50 s, respectively. Recovery index was significantly shorter after cisatracurium, 19.5 +/- 7.5 s vs. 33.7 +/- 18.6 s (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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D-TUBOCURARINE , PHARMACODYNAMICS , PHARMACOKINETICS , ATRACURIUM , BLOCK , PANCURONIUM , ISOFLURANE , HALOTHANE , DURATION , INFUSION