Effects of Succinylcholine on the Recovery of Vecuronium-induced Neuromuscular Block / 대한마취과학회지

ABSTRACT

BACKGROUND: Succinylcholine is commonly used for tracheal intubation during induction of anesthesia and followed by a nondepolarizing neuromuscular blocking drug for intraoperative muscle relaxation. We have determined whether the effect of succinylcholine used for endotracheal intubation on the recovery of vecuronium-induced neuromuscular block offers many changes in time course of neuromuscular block. METHOD: Forty ASA class 1 or 2 adult male patients were studied. Patients were premedicated with nalbuphine 10 mg and glycopyrrolate 0.2 mg and after induction of anesthesia with thiopental, anesthesia was maintained with 1~2% enflurane, and 50% nitrous oxide in oxygen. Twitch responses of adductor pollicis were measured acceleromyographically using 0.2 ms, 2 Hz, train of four (TOF) stimulation of ulnar nerve every 15 seconds. The patients were allocated randomly to following four groups; Ten patients received vecuronium 0.1 mg/kg only (group 1), remained thirty patients received succinylcholine 1.0 mg/kg first and vecuronium 0.1 mg/kg was administered at 0% (group 2, n=10), 25% (group 3, n=10), 75% (group 4, n=10) recovery of first twitch from succinylcholine-induced neuromuscular block respectively. RESULT: Clinical duration, recovery index, and TOF ratio of vecuronium were not significantly different between groups. CONCLUSION: Succinylcholine for endotracheal intubation during induction of anesthesia does not affect time course of action of vecuronium-induced neuromuscular block. The cause of this result suspect that the effect of succinylcholine might be masked by large dose of vecuronium (2XED95). Clinically, it is unlikely that prior administered succinylcholine 1 mg/kg influence the recovery of vecuronium-induced neuromuscular block.