Abstract
The authors studied the duration of action of vecuronium in 15 patients with normal renal function and 40 patients with chronic renal failure to evaluate the effect of secondary hyper-parathyroidism on the action of vecuronium. The patients were divided into four groups: 15 patients with normal renal function (Group A); nine patients with chronic renal failure who did not need haemodialysis (Group B); 15 anephric patients who did not require parathyroidectomy (Group C); and 16 anephrenic patients who underwent parathyroidectomy because of severe secondary hyperparathyroidism (Group D). The ratio of the height of the first twitch (T1) to the baseline value before vecuronium administration was measured by an electromyogram. Baseline T1 was obtained after anaesthesia induction with thiamylal iv. The time to 10% recovery of the first twitch (REC 10) after administration of vecuronium 0.12 mg · Kg−1 iv was measured in each group. Anaesthesia was maintained with isoflurane and nitrous oxide in oxygen, and supplemented with fentanyl iv. Patients in Group D showed shorter REC 10 (51 ± 4 min) than those in Groups B (71 ± 6 min) and C (80 ± 10 min) (P < 0.05), but similar REC 10 to patients in Group A (37 ±4 min). These results suggest that the duration of action of vecuronium in anephric patients with secondary hyperparathyroidism is shorter than in those without secondary hyperparathyroidism.
Résumé
Les auteurs étudient la durée d’action du vécuronium auprès de 15 patients avec une fonction rénale normale et de 40 patients avec une insuffisance rénale chronique afin d’évaluer l’effet d’une hyperparathyroïdïe secondaire sur l’action du vécuronium. Les patients sont répartis en quatre groupes: quinze patients avec une fonction rénale normale (Groupe A); neuf patients avec une insuffisance rénale chronique non hémodialysés (Groupe B); 15 patients anéphriques qui n’ont pas besoin d’une parathyroïdectomie (Groupe C) et 16 patients anéphriques qui subissent une parathyroïdectomie à cause d’une hyperparathyroïdie secondaire grave (Groupe D). Le rapport de la hauteur de la première contraction (T1) à la contraction de base avant l’administration de vécuronium est mesurée par un électromyogramme. Le T1 de base est obtenu après l’induction de l’anesthésie avec du thiamylal iv. Le temps de récupération à 10% dès la première contraction (REC 10) après l’administration iv de 0,12 mg · Kg−1 de vécuronium est mesuré dans chaque groupe. L’anesthésie est maintenue avec de l’isoflurane et du protoxyde d’azote dans l’oxygène et des suppléments de fentanyl iv. Les patients du groupe D montrent un plus court REC 10 (51 ± 4 min) que ceux du groupe B (71 ± 6 min), et du groupe C (80 ± 10 min) (P < 0,05), mais un REC 10 semblable aux patients du groupe A (37 ± 4 min). Les résultats suggèrent que la durée d’action du vécuronium chez les patients anéphriques est plus courte avec que sans hyperparathyroïdie secondaire.
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Takita, K., Goda, Y., Kemmotsu, O. et al. Secondary hyperparathyroidism shortens the action of vecuronium in patients with chronic renal failure. Can J Anaesth 42, 395–398 (1995). https://doi.org/10.1007/BF03015484
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DOI: https://doi.org/10.1007/BF03015484