comparison of Vecuronium - induced Neuromuscular Blockade in Pregnant and Nonpregnant Patients.
10.4097/kjae.1992.25.6.1182
- Author:
Surk Hwan CHOI
1
;
Hyung Chul SHIN
;
Sung Keun LEE
;
Ki Ryang AHN
;
Kyung Ho HWANG
;
Sung Yell KIM
Author Information
1. Department of Anesthesiology, College of Medicine, Soon Chun Hyang University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Neuromucular blocker;
Vecuronium;
Anesthesia;
Obstetrical
- MeSH:
Anesthesia;
Apgar Score;
Body Weight;
Cesarean Section;
Enflurane;
Female;
Glycopyrrolate;
Humans;
Hydroxyzine;
Intubation;
Neuromuscular Blockade*;
Pregnancy;
Pregnant Women;
Premedication;
Thiopental;
Ulnar Nerve;
Vecuronium Bromide*;
Wrist
- From:Korean Journal of Anesthesiology
1992;25(6):1182-1187
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This investigation was carried out in healthy twenty-four pregnant women undergoing elective Caesarean section and twelve nonpregnant women of the same age group, The premedication was performed with glycopyrroiate 0.2 mg and hydroxyzine l mg/kg IM respectively in the nonpregnant women, and glycopyrrolate 0.2 mg IM only in the pregnant women. Anesthesia was induced with IV pentothal sodium(4-5 mg/kg), vecuronium(0.08 mg/ kg) and ketamine(0.2 mg/kg) in the nonpregnant(Group I, N =12) or pregnant women(Group II, N=12), and pentothal sodium(4-Smg/kg), vecuronium(reducing dose of 20% from 0.08mg/kg) and ketamine(0.2 mg/kg) in the pregnant women(Group III, N=12). Anesthesia was maintained with 1-2% enflurane, 50% N2O, and O2. The ulnar nerve was stimulated supramaximally at the wrist with train-of-four stimuli every 20 sec. with ABM(Datex Co.) and the electromyographic response of the adductor pollicis muscle was measured. The onset of 50% block of first twitch height(T1) was faster in the group II(1.33+/-0.3min) than in the group I(1.9+/-0.6 min) and group III(1.6+/-0.3 min)(p<0.05). Also, the onset of 95% block of T 1 was faster in the group II(2.5+/-0.5 min) and III(1.6+/-0.3 min) than in the group I(3.8+/-0.9min)(p<0,05). The time of recovery of Tl to 10%, 25% and 50% of control were longer in the group II(34.9+/-5.3, 43.1+/-7.2 and 53.3+/-9.1 min respectively) and III(22.3+/-3.2, 29.5+/-4.5, 38.8+/-8.3 min respectively) than in the group I(21.1+/-4.8, 25.6+/-4.8 and 32.6+/-6.3 min respectively)(p<0.05). The conditions of intubation at 50% block of Tl were adequate in the group I and II but poor in the group III(p<0.05). Apgar score at 1 and 5 minutes after delivery were not significantly different between group II and III. Conclusively, administration of vecuronium dose on body weight basis in the pregnant women resulted in a more rapid onset and prolonged recovery of neuromuscular block than in the nonpregnant women without any adverse effects. Moreover, the conditions of intubation was poor when the dose of vecuronium was reduced by 20% in the pregnant women, Therefore, it is inadequate to reduce the dose of vecuronium concerning about relative overdose in the pregnant women undergoing Caesarean section.
