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British Journal of Anaesthesia Feb 1989Vecuronium was used as the only neuromuscular blocking agent in 81 paediatric patients (neonates to adolescents) during fentanyl and nitrous oxide anaesthesia. The...
Vecuronium was used as the only neuromuscular blocking agent in 81 paediatric patients (neonates to adolescents) during fentanyl and nitrous oxide anaesthesia. The thenar electromyogram was used to monitor neuromuscular blockade. Neonates and infants had a mean requirement of vecuronium 105 micrograms kg-1 during the first 1 h of anaesthesia, to establish and maintain 90-98% neuromuscular blockade, compared with a mean requirement of 217 micrograms kg-1 for children aged 3-10 yr (P less than 0.05). Vecuronium 100 and 150 micrograms kg-1 maintained neuromuscular blockade greater than 90% for 59 and 110 min, respectively, in neonates and infants, but only for 18 and 38 min in children and for 37 and 68 min in adolescents (P less than 0.05). Vecuronium may be regarded as a long-acting neuromuscular blocking agent in patients aged less than 1 yr.
Topics: Adolescent; Age Factors; Anesthesia, General; Child; Child, Preschool; Humans; Infant; Neuromuscular Junction; Synaptic Transmission; Time Factors; Vecuronium Bromide
PubMed: 2564279
DOI: 10.1093/bja/62.2.184 -
Veterinary Anaesthesia and Analgesia May 2015To compare baseline cardiovascular function in anesthetised pigs using either pancuronium or vecuronium as a neuromuscular blocker. (Clinical Trial)
Clinical Trial
OBJECTIVE
To compare baseline cardiovascular function in anesthetised pigs using either pancuronium or vecuronium as a neuromuscular blocker.
STUDY DESIGN
Retrospective, non-randomized comparison.
ANIMALS
Norwegian Land Race pigs (Sus scrofa domesticus) weighing mean 42 ± SD 3 kg.
METHODS
One hundred and sixteen animals from four different research protocols premedicated with identical doses of ketamine, diazepam, atropine and isoflurane, and anaesthetised with pentobarbital, fentanyl, midazolam and N(2)O were arranged into three uniform groups with respect to neuromuscular blocking agent: pancuronium bolus of 0.063 mg kg(-1) followed by 0.14 mg kg(-1) hour(-1) (n = 54), low-dose vecuronium 0.4 mg kg(-1) /0.2 mg kg(-1) hour(-1) (n = 29) and high-dose vecuronium 0.6 mg kg(-1) /0.3 mg kg(-1) hour(-1) (n = 33).
RESULTS
The majority of cardiovascular parameters demonstrated no significant differences between groups. For heart rate, there was an overall group difference, p = 0.036. Dromotropy was low in the pancuronium group, with an increased normalised PR-interval compared to the high-dose vecuronium group, median 0.200 interquartile range (0.190, 0.215) versus 0.182 (0.166, 0.199), p < 0.05. Left ventricular compliance was increased in pancuronium-treated animals, demonstrated as a reduction in the nonlinear end-diastolic pressure volume relationship β compared to both vecuronium groups, 0.021 (0.016, 0.025) versus 0.031 (0.025, 0.046) and 0.031 (0.022, 0.048), p < 0.05. The linear end-diastolic pressure volume relationship EDPVR(lin) was reduced as well in the pancuronium group, compared to the low-dose vecuronium group, 0.131 (0.116, 0.169) versus 0.181 (0.148, 0.247), p < 0.05.
CONCLUSIONS
There are only minor haemodynamic differences when using pancuronium compared to vecuronium in the fentanyl-pentobarbital-midazolam-N(2)O anesthetised domestic pigs. Furthermore, increasing doses of vecuronium have minimal haemodynamic effects.
CLINICAL RELEVANCE
Experimental studies in pigs using either pancuronium or vecuronium as a neuromuscular blocking agent are comparable with regard to cardiac and haemodynamic performance.
Topics: Animals; Dose-Response Relationship, Drug; Hemodynamics; Neuromuscular Nondepolarizing Agents; Pancuronium; Swine; Vecuronium Bromide
PubMed: 24985148
DOI: 10.1111/vaa.12198 -
Anesthesiology Apr 1991To compare the speed of onset, intubating conditions, duration of action, and recovery from neuromuscular blockade with vecuronium to those with succinylcholine, 40 ASA... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
To compare the speed of onset, intubating conditions, duration of action, and recovery from neuromuscular blockade with vecuronium to those with succinylcholine, 40 ASA physical status 1 or 2 children (ages 2-9 yr) were studied during N2O-O2-opioid anesthesia. Each child was randomly assigned to receive a bolus dose of one of the following muscle relaxants: succinylcholine 2.0 mg/kg (n = 10), vecuronium 0.1 mg/kg (n = 10), vecuronium 0.2 mg/kg (n = 10), or vecuronium 0.4 mg/kg (n = 10). The evoked electromyogram of the abductor digiti minimi to train-of-four stimulation was monitored. We found that with succinylcholine, the time to 95% twitch depression (speed of onset, mean +/- SD), 24 +/- 7 s, was significantly less than that with each dose of vecuronium: 0.1 mg/kg, 83 +/- 21 s; 0.2 mg/kg, 58 +/- 17 s; and 0.4 mg/kg, 39 +/- 11 s, respectively (P less than 0.05). The time to laryngoscopy and intubation did not differ significantly between succinylcholine (48 +/- 10 s) and vecuronium 0.4 mg/kg (57 +/- 13 s); however, both were significantly less than than with vecuronium 0.1 and 0.2 mg/kg (P less than 0.005). The intubating conditions were excellent in 100% of patients. The duration of action was least with succinylcholine (5.7 +/- 1.5 min) and increased with increasing doses of vecuronium: 0.1 mg/kg, 23.9 +/- 5.1 min; 0.2 mg/kg, 55.2 +/- 11.6 min; and 0.4 mg/kg, 74.6 +/- 9.9 min, respectively (P less than 0.001). The recovery index was most rapid with succinylcholine (1.6 +/- 0.4 min) and was slowest with vecuronium 0.4 mg/kg (22.6 +/- 2.1 min) (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Anesthesia, Intravenous; Child; Child, Preschool; Dose-Response Relationship, Drug; Electromyography; Fentanyl; Humans; Morphine; Muscle Relaxation; Random Allocation; Succinylcholine; Vecuronium Bromide
PubMed: 1672578
DOI: 10.1097/00000542-199104000-00006 -
Chemical Communications (Cambridge,... Apr 2024The binding affinity of pillar[6]MaxQ toward a panel of neuromuscular blockers and neurotransmitters was measured in phosphate buffered saline by isothermal titration...
The binding affinity of pillar[6]MaxQ toward a panel of neuromuscular blockers and neurotransmitters was measured in phosphate buffered saline by isothermal titration calorimetry and H NMR spectroscopy. efficacy studies showed that P6MQ sequesters rocuronium and vecuronium and reverses their influence on the recovery of the train-of-four (TOF) ratio.
Topics: Vecuronium Bromide; Rocuronium; Androstanols; Neuromuscular Nondepolarizing Agents; Calorimetry
PubMed: 38546190
DOI: 10.1039/d4cc00772g -
Ma Zui Xue Za Zhi = Anaesthesiologica... Sep 1985
Comparative Study Review
Topics: Anesthesia, General; Atracurium; Humans; Vecuronium Bromide
PubMed: 2878339
DOI: No ID Found -
Anesthesia and Analgesia Dec 2000We report a case of accidental epidural injection of vecuronium in a female patient who underwent hemorrhoidectomy using epidural anesthesia. Because epidural injection...
We report a case of accidental epidural injection of vecuronium in a female patient who underwent hemorrhoidectomy using epidural anesthesia. Because epidural injection of muscle relaxants may have serious side effects, immediate establishment of airway protection, monitoring of muscle relaxation, and follow-up for clinical signs of neurotoxicity are recommended.
Topics: Adult; Anesthesia, Epidural; Female; Humans; Injections, Intramuscular; Injections, Intravenous; Medication Errors; Neuromuscular Nondepolarizing Agents; Vecuronium Bromide
PubMed: 11094016
DOI: 10.1097/00000539-200012000-00046 -
British Journal of Anaesthesia Mar 2000
Topics: Evidence-Based Medicine; Humans; Neuromuscular Blockade; Neuromuscular Junction; Neuromuscular Nondepolarizing Agents; Postoperative Period; Vecuronium Bromide
PubMed: 10793585
DOI: 10.1093/oxfordjournals.bja.a013428 -
Journal of Clinical Anesthesia 1989Vecuronium was administered to patients in dosages of 0.1, 0.2, 0.3, and 0.4 mg/kg to determine the clinical efficacy of large doses of vecuronium. Onset times shortened... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
Vecuronium was administered to patients in dosages of 0.1, 0.2, 0.3, and 0.4 mg/kg to determine the clinical efficacy of large doses of vecuronium. Onset times shortened with larger doses up to 0.3 mg/kg. With 0.4 mg/kg, however, there was no significant improvement in onset time and the duration of action became unpredictable and often prolonged. Mean onset times were 172, 138, 106, and 100 seconds for the four groups, respectively. Prolonged duration of action (43, 96, 111, and 174 minutes, respectively) was observed with increasing dosages. Recovery rates for the first twitch response of the train-of-four stimulus from 10% to 25% were similar in all groups. There were no adverse hemodynamic effects secondary to large doses of vecuronium.
Topics: Adult; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Neuromuscular Junction; Randomized Controlled Trials as Topic; Time Factors; Vecuronium Bromide
PubMed: 2576217
DOI: 10.1016/0952-8180(89)90007-x -
Anesthesiology Jul 1994Cumulative effects (increased 25-75% recovery time with increasing dose) are evident with vecuronium but not with atracurium. Pharmacokinetic simulations suggest that... (Clinical Trial)
Clinical Trial
BACKGROUND
Cumulative effects (increased 25-75% recovery time with increasing dose) are evident with vecuronium but not with atracurium. Pharmacokinetic simulations suggest that vecuronium's cumulation occurs as recovery shifts from distribution to elimination whereas atracurium's recovery always occurs during elimination. The purpose of this study was to examine this pharmacokinetic explanation.
METHODS
We assigned 12 volunteers to receive atracurium of vecuronium on three occasions during nitrous oxide-isoflurane anesthesia. Evoked adductor pollicis twitch tension was monitored. On occasion 1, the dose expected to produce 95% block (ED95) was estimated for each subject. On occasions 2 and 3, 1.2 or 3.0 multiples of ED95 were given as a bolus. Plasma was sampled for 128 min to determine muscle relaxant concentrations; pharmacodynamic modeling was used to determine effect-compartment drug concentrations (Ce). For each drug, recovery time, recovery phase half-life (rate of decrease in Ce during recovery), and Ce at 25% and 75% recovery were compared between doses.
RESULTS
Atracurium's recovery time increased 2.4 +/- 2.2 min (mean +/- SD) with the larger dose, less than the increase with vecuronium (8.2 +/- 3.8 min). Atracurium's recovery phase half-life was 14.6 +/- 1.7 and 20.1 +/- 2.3 min with the small and large doses (P < 0.05); vecuronium's recovery phase half-life increased similarly from 13.5 +/- 2.3 to 18.5 +/- 5.0 min (P < 0.05). At 75% recovery, vecuronium's Ce decreased from 65 +/- 18 ng/ml with the small dose to 55 +/- 15 ng/ml with the large dose (P < 0.05). Assuming that neuromuscular junction sensitivity was constant, this difference could be explained by considering neuromuscular effects of vecuronium's metabolite, 3-desacetylvecuronium.
CONCLUSIONS
Although vecuronium was cumulative (as predicted), atracurium was also slightly cumulative. Inconsistent with our hypothesis, recovery phase half-lives for both drugs increased similarly between doses; therefore, differences in cumulation were not solely explained by pharmacokinetics of the muscle relaxant. It appears that 3-desacetylvecuronium contributes to vecuronium's cumulative effect, even after usual clinical doses.
Topics: Adult; Atracurium; Body Fluid Compartments; Female; Half-Life; Humans; Male; Models, Biological; Vecuronium Bromide
PubMed: 7913801
DOI: No ID Found -
The American Journal of Emergency... Jul 1992
Topics: Bone and Bones; Emergencies; Female; Humans; Infant; Intubation, Intratracheal; Resuscitation; Vecuronium Bromide
PubMed: 1352102
DOI: 10.1016/0735-6757(92)90019-t