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Published online by Cambridge University Press: 28 January 2005
Summary
Background and objective: Neuromuscular block times, quality of muscle relaxation for tracheal tube insertion, and the haemodynamic effects after cisatracurium and vecuronium under sevoflurane–remifentanil anaesthesia were compared in elderly patients.
Methods: The study was performed in 40 patients over 65 yr of age. Anaesthesia was induced with thiopental, and maintained with sevoflurane in N2O/O2 and remifentanil. Cisatracurium 0.15 mg kg−1 or vecuronium 0.1 mg kg−1 were administered after induction. Intubation was attempted when neuromuscular block was 95%. Onset time, clinical duration of action, recovery index, spontaneous recovery time and tracheal intubation conditions were assessed. Haemodynamic parameters were also monitored.
Results: The average ages of the patients were 72.5 ± 5.1 and 73.6 ± 6.3 in the cisatracurium and vecuronium groups, respectively. Onset time was significantly shorter after vecuronium, 158 ± 34 s vs. 200 ± 50 s, respectively. Recovery index was significantly shorter after cisatracurium, 19.5 ± 7.5 s vs. 33.7 ± 18.6 s (P < 0.05). Clinical duration and spontaneous recovery time were similar in both groups as well as haemodynamic variables.
Conclusions: In elderly patients, vecuronium has a faster onset time while cisatracurium has a shorter recovery index under sevoflurane–remifentanil anaesthesia.