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
Publication statusPublished - 2000

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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

Cite this

Fu, W., Klein, K. W., White, P. F., Chiu, J. W., Lemmens, H. J. M., Whalley, D. G., ... Greenberg, C. P. (2000). Rapacuronium recovery characteristics and infusion requirements during inhalation versus propofol-based anaesthesia. British Journal of Anaesthesia, 85(2), 302-305.