Dose Response Relationship of Neuromuscular Blockade, Intubation Conditions and Cardiovascular Changes With Chandonium Iodide

Abstract

One hundred and forty ASA physical status I and II patients undergoing general or gynaecological surgery were the subjects of this study. Patients were randomly assigned into five groups receiving 100, 150, 180, 200 and 250~gIkg lV. of chandonium iodide after induction of general anaesthesia with thiopentone. Neuromuscular blockade was assessed clinically, as well as, with twitch response/train of four using myotest nerve stimulator. Increasing dosage of chandonium iodide decreased the time to onset of jaw relaxation and apnoea (p<O.Ol) and caused linear increase in the duration of neuromuscular blockade from 10.90 ± 5.:n to 25.18 ± 7.15 min (p<O.Ol) over the dosage rage of 100 to 250 J.lglkg.Intubation conditions also improved with increasing doses of chandonium iodide, so that, although intubation was possible in all the patients, grading of good intubation conditions were achieved in 64, 80,88,100 and 100% ofpatients in groups I to V respectively. 200 J.lglkg ofchandonium iodide produced ideal intubation conditions. Recovery to spontaneous ventilation was rapid and smooth, further facilitated with neuromuscular antagonists. Short lasting increase in heart rate and blood pressure was seen which was neither dose dependent nor outlasting the duration of neuromuscular blockade.