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KMID : 0378019900330070083
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New Medical Journal
1990 Volume.33 No. 7 p.83 ~ p.90
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The Neuro-Muscular Blocking Effect of Vecaron^(®) in Renal Transplantation
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박철주/Park, Cheol Joo
문동언/이승균/최종호/김성년/Moon, Dong Eon/Lee, Sung Kyun/Choi, Jong Ho/Kim, Sung Nyeun
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Abstract
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The important points on use of muscle relaxants in advanced renal failure patients, who are undergoing renal transplantation, are that the drug should be free from risk of respiratory depression, originated from minimal dependency of excretion upon renal route, and have minimal hemodynamic effects.
It has been known that most of non-depolarizing neuromuscular blocking agents affect autonomic nervous system, directly or indirectly, to one degree or another, so the drugs bring about hemodynamic change.
Vecuronium, intermediately acting non-dopolarizing neuromuscular blocking agent, has been known as a safe muscle relaxant in advanced renal failure patient because of high dependency of excretion on biliary route. It has been also known that vecuronium acts on neruomuscular junction. most specfically and causes least hemodynamic change among non-depolirizing neuromuscular blockers.
It is imperative to keep hemodynamic system stable for the adequate perfusion of transplanted kidney. In this point of view, vecuronium is the choice of muscle relaxant for renal transplantation.
We evaluated and compared the degree of maximal relaxation, onset time, duration of action, recovery index by "Train of Four" stimulation method, between Norcuron® and Vecaron® both are vecuronium preparations, and also compared the hemodynamic changes, before and after administration of two drugs, the degree of postoperative respiratory depression, by measuring tidal volume and minute volume preoperatively and postoperatively in renal transplantation.
The results were as follows
1) There was no significant difference in onset of action between Norcuron® and Vecaron® groups.
2) There was no significant difference in degree of maximal relaxation between Norcuron® and Vecaron® groups.
3) There was no significant difference in duration of action between Norcuron® and Vecaron® groups.
4) There was no significant difference in recovery index between Norcuron® and Vecaron® groups.
5) The changes of arterial blood pressure, pulse rate, cardiac output, and CVP before
and after administration of drugs were not significantly different statistically between Norcuron® and Vecaron® group.
6) The tidal volume and minute volume measured after operation are not decreased
compared to preanesthetic values in all patients of Norcuron® and Vecaron® group.
7) Marked individual variances of recovery indicies and duration were observed in Norcuron® and Vecaron® groups.
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