Comparison of intra operative muscle relaxation and neuro muscular recovery from continuous infusion of vecuronium and atracurium in ASA grade I @ II patients undergoing midline and paramedian laparotomies

Abstract

Background: Vecuronium and Atracurium are two muscle relaxants that come close to fulfill most of the criteria for using them as continuous infusion. In this study in sixty adult patients of either sex, 25-45 years of age, belonging to ASA physical status I&II, were chosen, who were scheduled for midline and paramedian laparotomies under GA. Objective: (1) To assess the recovery time from neuromuscular blockade on stopping the infusion of vecuronium and atracurium. (2) To assess the haemodynamic performance in peri operative period. Materials & Methods: Patients were randomly allocated into two equal groups and received either vecuronium 0.8-1 g/kg/min following a bolus dose of 0.1mg/kg or Atracurium 4-12 g/kg/min following a bolus dose of 0.5 mg/kg. Intravenous infusion of muscle relaxants were adjusted to maintain 90% of neuromuscular blockade monitored by stimulating ulnar nerve at the wrist by a peripheral nerve stimulator throughout surgery. Results: The median time & interquartile range which were taken from intravenous bolus dose to 10% recovery was less in Vecuronium group (23±2 min) than atracurium group (25.± 2 min). Vecuronium (median 15.5 ± 3 min) took less time to achieve steady state of block after starting infusion than atracurium (median 18 ± 3 min). Conclusions: Patients who received vecuronium recovered early from relaxant effect with more stable hemodynamics.

Keywords

• Infusion
• Muscle relaxant
• Vecuronium
• Atracurium
• Peripheral nerve stimulator