Pulmonary Function following ??Pretreatment?? Dose of Pancuronium in Volunteers

Lung function and clinical evidence of muscle weakness were assessed in 12 ASA I patients who received vecuronium 0.01 mg kg' 1 pretreatment as a part of their anaesthetic management, before and 3 min after pretreatment. Most patients demonstrated ptosis and diplopia, while five of the 12 were unable to raise the head for > 4 s and had difficulty in swallowing. Significant reductions occurred in forced vital capacity, forced expiratory volume in 1 s, and maximum mid-expiratory flow rate. Among static lung volumes, functional residual capacity and expiratory reserve volume decreased significantly. However, these changes were not serious enough to cause clinically significant impairment of coughing or a decrease in oxygen saturation in any patient.

Section: Commentmentioning

confidence: 97%

Lung Function After Vecuronium Pretreatment in Young, Healthy Patients

Mahajan¹,

Laverty²

1992

“…This view was supported by our findings, since the frequency of general discomfort was 6%, which was in contrast to their report of general discomfort in 80% of the patients receiving pancuronium 0.015 mg kg" 1 , which is a dose similar to the standard dose, used in the present study, of 1 mg in a 70-kg person. The expectation put forward by Rao and Jacobs (1980), that ventilatory responses to precurarization may be aggravated by premedication, was not substantiated.…”

Section: Discussionmentioning

confidence: 94%

“…Variable success has been reported with this procedure in decreasing muscle fasciculations, postoperative muscle pain, and the frequency of cardiac arrhythmia (Jorgensen et al, 1980;Ferguson and Bevan, 1981;Ferres et al, 1983). However, precurarization itself is not free from unpleasant and serious reactions, and may result in changes in pulmonary function and neuromuscular transmission (Howardy-Hansen et al, 1980;Rao and Jacobs, 1980;Engbaek and Viby-Mogensen, 1984;Engbaek et al, 1985). Alcuronium has never been included in such studies and data with vecuronium have been published only for awake nonpremedicated volunteers.…”

mentioning

confidence: 99%

Side Effects and Changes in Pulmonary Function After Fixed Dose Precurarization With Alcuronium, Pancuronium or Vecuronium

Motsch

Fuchs

Hoch

et al. 1987

On hundred and sixty premedicated patients undergoing surgery were assessed for changes in pulmonary function and signs of partial neuromuscular blockade following precurarization with a fixed dose of alcuronium 2 mg, pancuronium 1 mg or vecuronium 1 mg, and the efficacy of the drugs in the prevention of suxamethonium-associated side effects was compared. In this respect, no differences were observed between the three drugs. Pretreatment with alcuronium and pancuronium was followed by small decreases in pulmonary function. Statistically significant changes were seen only when vecuronium 1 mg was used as the fixed-dose precurarization agent.

“…These measurements were mainly effort-dependent and therefore could account for the contradictory results. In one study, Rao and Jacobs [11] demonstrated a significant decrease in forced inspiratory and expiratory flow rates without any change in PEFR after a " pretreatment" dose of pancuronium 0.014 mg kg" 1 in 15 volunteers. Engbaek and colleagues [12], on the other hand, reported a significant reduction in PEFR in healthy volunteers after 0.01 mg kg" 1 of either vecuronium or pancuronium, or pancuronium 0.015 mg kg" 1 , while VC, FEV, and NIP remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary function and head lift during spontaneous recovery from pipecuronium neuromuscular block

Mikatti

Wilson

Pollard

et al. 1995

We have studied in seven healthy conscious volunteers the correlation between the electromyographic (EMG) and clinical criteria used to identify adequate recovery from sub-paralysing doses of pipecuronium. Pipecuronium (mean dose 1.88 (range 0.92-3.16) mg) was administered to reach a T4/T1 ratio of 0.5; full recovery to 1.0 was produced in a mean time of 25.3 (14-39) min. During recovery from neuromuscular block, we measured tidal volume, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) negative inspiratory pressure (NIP), peak expiratory flow rate (PEFR), mid-expiratory flow rate (MEFR) and 5-s head lift. The assessments were started when the train-of-four (TOF) ratio reached 0.5 +/- 0.001 and repeated at each 0.1 +/- 0.001 increase up to a ratio of 1.0. All volunteers showed ptosis and diplopia after the first dose and difficulty in swallowing with subsequent doses. They also experienced a pleasant, relaxing sedative sensation. All could sustain head lift for 5 s at a TOF ratio of 0.5 and higher, except for one subject who could not lift his head only at a ratio of 0.5. There was a statistically significant decrease in FVC, FEV1 and PEFR with a nonsignificant decrease in other pulmonary measurements, except for NIP which only decreased significantly at a ratio of 0.5. These changes are probably of no clinical importance. All the measured respiratory variables returned to control values at a TOF ratio of 0.9.