Rapacuronium recovery characteristics and infusion requirements during inhalation versus propofol-based anaesthesia

W. Fu, K. W. Klein, P. F. White, J. W. Chiu, H. J M Lemmens, D. G. Whalley, D. R. Drover, C. P. Greenberg

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

We examined the effect of four maintenance anaesthetics on the neuromuscular blocking activity and spontaneous recovery characteristics after a short-term infusion of rapacuronium. Eighty ASA I-III adult patients undergoing elective surgery were studied at four centres. Anaesthesia was induced with propofol 1.5-2.5 mg kg-1 and fentanyl 1-2 μg kg-1, followed by a bolus of rapacuronium 1.5 mg kg-1. The patients were randomized to receive either desflurane (2-4% end-tidal, ET), sevoflurane (0.75-1.5% ET), isoflurane (0.4-0.8% ET), or a propofol infusion (75-150 μg kg-1 min-1) for maintenance of anaesthesia in combination with nitrous oxide (60-70%) in oxygen. When the first twitch (T1) of a train-of-four stimulus (using the TOF Guard(®) accelerometer) returned to 5%, an infusion of rapacuronium was started at 3 mg kg-1 h-1 and adjusted to maintain T1/T0 at 10%. The duration of infusion lasted between 45 and 60 min, and the average infusion rates of rapacuronium were similar in all groups, ranging from 1.6 to 2.5 mg kg- 1 h-1. There were no significant differences among the groups in the times for T1/T0 to return to 25%, 75% or 90%, or for T4/T1 to return to 70% and 80% upon discontinuation of the infusion. When potent inhalation anaesthetics are used in clinically relevant concentrations for maintenance of anaesthesia, the neuromuscular recovery profile of rapacuronium administered as a variable-rate infusion for up to I h is similar to that found with a propofol-based anaesthetic technique.

Original languageEnglish (US)
Pages (from-to)302-305
Number of pages4
JournalBritish Journal of Anaesthesia
Volume85
Issue number2
DOIs
StatePublished - Jan 1 2000

Keywords

  • Anaesthetics i.v., propofol
  • Anaesthetics, volatile, desflurane
  • Anaesthetics, volatile, isoflurane
  • Anaesthetics, volative, sevoflurane
  • Monitoring, acceleromyography
  • Neuromuscular block, rapacuronium

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Fu, W., Klein, K. W., White, P. F., Chiu, J. W., Lemmens, H. J. M., Whalley, D. G., Drover, D. R., & Greenberg, C. P. (2000). Rapacuronium recovery characteristics and infusion requirements during inhalation versus propofol-based anaesthesia. British Journal of Anaesthesia, 85(2), 302-305. https://doi.org/10.1093/bja/85.2.302