Abstract
Neuromuscular blockade during surgery was provided with vecuronium in 24 adult patients in end-stage renal failure and in 21 normal patients who served as controls. Dose response curves were constructed which showed that the effective doses required to produce 50, 90 and 95 per cent neuromuscular blockade in patients with renal failure were 27.5, 43 and49fig-kg-1 respectively. These were not significantly different from the doses of 31, 49 and 57 fig-kg-1 in the normal patients. Repeated small dosesof0.01 mg’kg-1 hada significantly longer duration of action and were associated with some cumulation in the renal failure group. Recovery from the block occurred rapidly after neostigmine, was no different in renal failure and was not associated with recurarization. It is concluded that, when given to subjects in renal failure, vecuronium offers advantages over established agents such as shorter duration of action and easy reversibility.
Résumé
Le bloc neuromusculaire a été effectué avec du vécuro-nium chez 24 patients en defaillance rénale terminate et chez 21 patients normaux qui out constimé le groupe contrôle. Les courbes de réponse qu’on a établies onl montré que les doses nécessaires pour produire un bloc neuromusculaire de 50, 90 et 95 pour cent étaient respectivement de 27.5, 43 et 49 fμ.gkg-1. Ces doses ne diffèrent pas sensiblement des doses nécessaires chez les patients normally qui sont respectivement de 31, 49 et 57 Des petites doses répétées de 0.01 mg-kg-1 provoquaient un bloc neuromusculaire de plus longue durée possiblement relié à un certain degré d’accumulation dans le groupe en défaillance rénale. La disparition du bloc s’est effectuée rapidement à la suite de néostigmine dans t’un el I’autre groupes et on n’a pas observé de récurarisation chez les insuffisants rénaux. On conclut que le vécuronium, administré à des patients en défaillance rénale possède certains avamages sur les autres agents connus, en particulier une durée d’action plus courte et une réponse assurée a la néostigmine.
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Bevan, D.R., Donati, F., Gyasi, H. et al. Vecuronium in renal failure. Can Anaesth Soc J 31, 491–496 (1984). https://doi.org/10.1007/BF03009532
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DOI: https://doi.org/10.1007/BF03009532