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Canadian Journal of Anaesthesia

, Volume 44, Issue 11, pp 1208–1210 | Cite as

Onset of vecuronium neuromuscular blockade at the hand with an arterio-venous shunt

  • Hiroshi Iwasaki
  • Masanori Yamauchi
  • Eichi Narimatsu
  • Michiaki Yamakage
  • Hideaki Tsuchida
  • Akiyoshi Namiki
Brief Reports
Accepted:

Abstract

Purpose

To evaluate the onset of vecuronium neuromuscular blockade in the hand with an arteno-venous shunt for haemodialysis.

Methods

In 15 adult patients receiving haemodialysis for renal failure the onset of vecuronium-induced neuromuscular blockade after 0.08 mg·kg−1 vecuroniumiv was measured. Using train-of-four mechanomyographic monitoring, the force of contraction of the adductor pollicis of both hands with and without arteno-venous shunt was measured simultaneously.

Results

The times from the injection to the first depression of twitch response (latent onset) and 95% twitch depression (onset) in the hand with and without arteno-venous shunt were114.7 ± 33.4 and 218.7 ± 59.9 and 117.3 ± 34.3 and 208.7 ± 60.9 sec respectively. No difference in the onset of vecuronium neuromuscular blockade in the hand an arterio-venous shunt was demonstrated.

Conclusion

The presence of an artenovenous fistula does not modify the onset on neuromuscular blockade. Either arm can be used to monitor onset of neuromuscular blockade in chronic renal failure patients with an arterio-venous shunt in the hand for haemodialysis

Keywords

Onset Time Vecuronium Neuromuscular Blockade Neuromuscular Block Regional Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Évaluer au niveau de la main l’installation du bloc neuromusculaire au vécuronium chez des porteurs d’un shunt arténoveineux intallé pour l’hémodialyse.

Méthodes

On a mesuré chez 15 adultes hémodyalisés pour insuffisance rénale l’intallation du bloc neuromusculaire après l’administration de 0.08 mg·kgt-1 iv de vécuronium. Des moniteurs mécanomyographiques ont servi à mesurer le force de contraction de l’adducteur du pouce aux deux mains dont celle du shunt arténoveineux.

Résultats

Les intervalles mesurés entre l’injection et la dépression du premier twicht (latence d’installation) et 95% (installation) avec et sans snunt artérioveineux étaient respectivement de 114,7 ± 33,4 et 218,7 ± 59,9 et 117,3 ± 34,3 et 208,7 ± 60,9 s. Lintallation du bloc neuromusculaire au vécuronium ne différait pas du côté shunt.

Conclusion

La présence d’une fistule arténoveineuse ne modifie pas l’installation du bloc neuromusculaire. On peut utiliser indifféremment les deux bras pour le monitorage de l’intallation du bloc neuromusculaire chez les insuffisants rénaux chroniques porteur d’un shunt artérioveineux pour hémodialyse.

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Copyright information

© Canadian Anesthesiologists 1997

Authors and Affiliations

  • Hiroshi Iwasaki
    • 1
  • Masanori Yamauchi
    • 1
  • Eichi Narimatsu
    • 1
  • Michiaki Yamakage
    • 1
  • Hideaki Tsuchida
    • 1
  • Akiyoshi Namiki
    • 1
  1. 1.Department of AnesthesiologySapporo Medical University, School of MedicineChuoku, SapporoJapan

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