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Canadian Journal of Anesthesia 48:34-37 (2001)
© Canadian Anesthesiologists' Society, 2001
General Anesthesia

High concentration sevoflurane induction of anesthesia accelerates onset of vecuronium neuromuscular blockade

Shigeki Yamaguchi, MD PhD, Hirotoshi Egawa, MD, Keiko Okuda, MD, Mutsuo Mishio, MD PhD, Yasuhisa Okuda, MD PhD and Toshimitsu Kitajima, MD PhD

From the Department of Anesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi 321-0293, Japan.

Address correspondence to: Shigeki Yamaguchi MD PhD. Phone: 81-282-861111; Fax: 81-282-860478; E-mail: sigeki{at}peach.ocn.ne.jp

Purpose: To investigate neuromuscular block using accelography after administration of vecuronium under sevoflurane 8% induction and maintenance with sevoflurane 2% in adults.

Methods: Patients were allocated to three groups: (1) group I: anesthesia was induced and maintained with propofol and fentanyl (n=15), (2) group II: anesthesia was induced with propofol and maintained with N2O(66%)-O2-sevoflurane 2% (n=15), (3) group III: anesthesia was induced with sevoflurane 8% using a vital capacity inhalation induction and maintained with N2O(66%)-O2-sevoflurane 2% (n=15). 0.1 mg•kg–1 vecuronium was used for paralysis three minutes after anesthetic induction and reversed using intravenous 0.04 mg•kg–1 neostigmine with 0.02 mg•kg–1 atropine when the train-of-four (TOF) ratio returned to 25%.

Results: The onset time from initial administration of vecuronium to maximal block in the group III was shorter than that in the groups I and II (139 ± 35, 193 ± 35 and 188 ± 47s, respectively: P < 0.05). The clinical duration from maximal block to 25% recovery of TOF ratio in group II and III was longer than that in the group I (47 ± 15, 48 ± 14 and 36 ± 10 min, respectively: P < 0.05). The reversal times from administration of neostigmine to 75% of TOF ratio in groups II and III were longer than that in the group I (196 ± 53, 208 ± 64 and 136 ± 28s, respectively: P < 0.05).

Conclusions: Vital capacity inhalation induction of anesthesia with sevoflurane accelerates onset and prolongs duration of vecuronium neuromuscular block compared with propofol-fentanyl anesthesia.




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S. Yamaguchi, T. Ikeda, K. Wake, Y. Okuda, and T. Kitajima
A sevoflurane induction of anesthesia with gradual reduction of concentration is well tolerated in elderly patients: [L'induction de l'anesthesie au sevoflurane, avec une reduction graduelle de la concentration, est bien toleree par les patients ages]
Can J Anesth, January 1, 2003; 50(1): 26 - 31.
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