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Revista Brasileira de Anestesiologia

On-line version ISSN 1806-907X


MARIA, Luís Fernando Rodrigues; TARDELLI, Maria Angela  and  RODRIGUES, Rita de Cássia. Effect of atracurium on pancuronium-induced neuromuscular block recovery. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.3, pp. 311-318. ISSN 1806-907X.

BACKGROUND AND OBJECTIVES: Additional neuromuscular blocker doses are in general needed during wall closing after abdominal surgeries. This study aimed at determining during partial pancuronium-induced neuromuscular block recovery, the effect of additional atracurium dose on spontaneous neuromuscular block recovery. METHODS: Participated in this study 30 patients divided in two groups: pancuronium group (n = 14) and atracurium group (n = 16). Neuromuscular function was continuously monitored by accelerometry of abductor pollicis muscle using TOF to supramaximally stimulate ulnar nerve. Anesthesia was induced with propofol, fentanyl and 0.08 pancuronium, and was maintained with 60% N2O in oxygen and 0.5% isoflurane expired concentration. When T1 returned to 25% of control, 0.025 pancuronium or 0.20 atracurium were administered to pancuronium or atracurium group, respectively. Time for spontaneous T1 recovery = 10%, 25%, 75% of recovery index (RI 25-75%) and time to T4/T1 equal 0.8 after complementary dose, were recorded. RESULTS: There were no differences between groups on T1 spontaneous recovery to 10% (45.00 ± 15.50 vs. 49.69 ± 9.41), 25% (61.64 ± 18.58 vs. 64.25 ± 12.51) and 75% (94.00 ± 28.52 vs. 84.69 ± 16.50). Recovery index (RI 25-75%) and time to T4/T1= 0.8 were shorter in the atracurium group. CONCLUSIONS: In this study, atracurium complementation has made no difference in initial spontaneous recovery of pancuronium-induced neuromuscular block, but has decreased total recovery time in 20%.

Keywords : MONITORING [neuromuscular function]; NEUROMUSCULAR BLOCKERS [Non-depolarizing]; NEUROMUSCULAR BLOCKERS [atracurium, pancuronium].

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