Canadian Journal of Anesthesia, Vol 41, 908-912, Copyright © 1994 by Canadian Anesthesiologists' Society

ARTICLES

Neuromuscular effects of vecuronium and neostigmine in Montreal and Paris

Y Salib, J Frossard, B Plaud, B Debaene, C Meistelman and F Donati
Department of Anaesthesia, Royal Victoria Hospital, Montreal, Quebec.

The potency of vecuronium was reported to be greater in Montreal than in Paris. This study was designed to determine whether there were differences in onset, duration, and reversibility with neostigmine between both centres. Twenty ASA I or II adults (ten men, ten women), aged 18-65 yr were studied in each of the two cities, during a standard thiopentone-fentanyl-nitrous oxide (60-70%) - isoflurane 0.5% end-tidal anaesthetic. Train-of-four stimulation was applied every 20 sec to the ulnar nerve at the wrist and the force of contraction of the adductor pollicis muscle was measured. Vecuronium, 0.1 mg.kg-1, was given as a bolus, and neostigmine, 0.04 mg.kg-1, was administered, with atropine 0.02 mg.kg-1, at 25% first twitch height recovery. Onset time to maximum blockade was (mean +/- SD) 3.9 +/- 1.3 min in Paris vs 4.5 +/- 1.3 min in Montreal (NS). Duration from injection to 25% first twitch recovery was shorter (28.5 +/- 6.8 min) in Paris than in Montreal (39.1 +/- 7.3 min) (P < 0.0001). Time from injection of neostigmine to a train-of-four ratio of 70% was not different in Paris (6.3 +/- 2.2 min) from Montreal (5.6 +/- 1.9 min). It is concluded that the duration of an "intubating" dose of vecuronium is longer in Montreal, but, when given at 25% first twitch recovery, neostigmine has the same efficacy in Montreal as in Paris.

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