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KMID : 0356919940270070748
Korean Journal of Anesthesiology
1994 Volume.27 No. 7 p.748 ~ p.753
The Effect of Propofol on the Recovery Period of Vecuronium Induced Neuromuscular Blockade



Abstract
Propofol (2.6-diisopropyl phenol) is chemically unrelated to the other intravenous anesthetic agents. The compound is an oil at room temperature and is formulated as an 1% emulsion in soybean oil and egg phosphate. Rapid induction of anesthesia
and
recovery suggest that it will be valuable for ambulatory patients who are undergoing brief procedures and for sedation in intensive care units. The original formulation of propofol in cremophor may potentiate vecuronium neuromuscular blockade in
both
experimental and clinical setting. There were a little reports interaction between the emulsion formulation of propofol and vecuronium.
This study was designed to investigate the effect of propofol on the recovery period of vecuronium neuromuscular blockade in humans. Neuromuscular block was monitored by measuring the force of contraction of the adductor pollicis muscle after
train
of
four stimulation of ulnar nerve, using ABM (Anesthesia and Brain activity Monitor, Datex CO, Finland). Fourty-two patients undergoing gynecological operations were included. All patients conformed to ASA physical states class 1 or 2. All patients
were
anesthetized by continuous lumbar epidural block with 1.5% lidocaine 4 mg/kg followed by general anethesia, with droperidol, 2.5% pentothal sodium, and vecuronium administered intravenously.
@ES Patients were classified 3 groups, as follows;
@EN Group ¥°(control group n=14): vecuronium 0.1 mg/kg i.v. only
Group ¥±(n=14): propofol, 1 mg/kg i.v. at the recovery time of Train of Four ratio 25%
Group ¥²(n=14): propofol, 2 mg/kg i.v. at the recovery time of Train of Four ratio 25%
We monitered the recovery index (ToF 25-50%, 25-75%) and the time and degree of maximal depression in propofol groups.
@ES Results were as follows:
@EN 1) Recovery Index-50 9 TOF 25-50%): The recovery time from TOF 25% to 50% were, 332¡¾47.2, 445¡¾54.3, 765¡¾292.0 secs in groups ¥°,¥±,¥², respectively. (p<0.05)
2) Recovery Index-75 (ROF 25-755): The recovery time from TOF 25% to 75% were, 742¡¾156.0, 948¡¾194.0, 1494¡¾499.0 secs, in groups ¥°,¥±,¥², respetively. (p<0.05)
3) The time and degree of maximal twitch depression after injection of propofol: 20¡¾4.0% of maximal twitch depression were observed for 25¡¾15.2 sec after injection of propofon of propofol in 3 patients of Group ¥±, and 17¡¾4.8% of maximal
twitch
depression were observed for 190¡¾130.0 sec after injection of propofol in 7 patients of Group ¥².
With the above results, we concluded that propofol has a synergistic effect on the recovery period of vecuronium induced neuromuscular blockade.
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