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ROCURONIUM - VECURONIUM INTERACTION REVISITED BY AN ALTERNATE METHOD

Department of Anesthesia, Hospital Clinicas Caracas & Policlinica Mendez Gimon. Caracas - Venezuela

INTRODUCTION

Beside regression plotting of transformed data, potency can be obtained from a single data point if the slope of this relationship is assumed, averaging individual estimates determined by using the modifications of the Hill equation (1, 2). The interaction between rocuronium (ROC) and vecuronium (VEC) already studied by others (3) was revisited by using such an alternate method.

METHODS

After institutional informed and signed consent 135 elective patients (44±4 years, 68±3 Kg) anesthetized with intravenous agents and ventilated with nitrous oxide-oxygen, were randomly allocated to nine groups (n=15) according to the amount and type of muscle relaxant administered. Single drug dose-response relationship were concluded first using ROC 50, 100 and 200 µg•Kg^-1 or VEC 10, 20 and 30 µg•Kg^-1 and ED₅₀'s determined by the above mentioned method, using the maximal effect obtained by electromyography and train-of-four stimulation. Subsequently ED₅₀ for the ROC+VEC combination was calculated using 0.2, 0.3 and 0.4 fractions of each ED₅₀ by the same alternate method. An algebraic analysis was used to identify the type of interaction: (dr/(ED₅₀)r+dv(ED₅₀)v) (3).

RESULTS

Algebraic analysis shows a value less than 1 indicating additivism (Table 1). For comparison results from a previous work using log/probit transformation for calculations are also included (3).

Highly similar figures obtained by either one results suggest that this alternate method is a reliable and useful tool for the calculation of a dose-response relationship and seems to be used for the first time for VEC and it's interaction with ROC.

REFERENCES

1 : Anesth Analg (2000) 90: 1191.[Abstract/Free Full Text]

2 Anesthesiology (1994) 81: 159.

3 ,: Br J Anaesth (1995) 75: 37.[Abstract/Free Full Text]

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