Onset of vecuronium neuromuscular blockade at the hand with an arterio-venous shunt.

Abstract

PURPOSE:

To evaluate the onset of vecuronium neuromuscular blockade in the hand with an arterio-venous shunt for haemodialysis.

METHODS:

In 15 adult patients receiving haemodialysis for renal failure the onset of vecuronium-induced neuromuscular blockade after 0.08 mg-kg-1 vecuronium i.v. was measured. Using train-of-four mechanomyographic monitoring, the force of contraction of the adductor pollicis of both hands with and without arterio-venous shunt was measured simultaneously.

RESULTS:

The times from the injection to the first depression of twitch response (latent onset) and 95% twitch depression (onset) in the hand with and without arterio-venous shunt were 114.7 +/- 33.4 and 218.7 +/- 59.9 and 117.3 +/- 34.3 and 208.7 +/- 60.9 sec respectively. No difference in the onset of vecuronium neuromuscular blockade in the hand an arterio-venous shunt was demonstrated.

CONCLUSION:

The presence of an arteriovenous fistula does not modify the onset on neuromuscular blockade. Either arm can be used to monitor onset of neuromuscular blockade in chronic renal failure patients with an arterio-venous shunt in the hand for haemodialysis.

• Authors: H Iwasaki, M Yamauchi, E Narimatsu, M Yamakage, H Tsuchida, A Namiki
• Journal: Canadian journal of anaesthesia = Journal canadien d'anesthesie (Can J Anaesth) Vol. 44 Issue 11 Pg. 1208-10 (Nov 1997) ISSN: 0832-610X [Print] United States
• PMID: 9398964 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Neuromuscular Blocking Agents
• Vecuronium Bromide

Topics

• Adult
• Anesthesia, Intravenous
• Arteriovenous Shunt, Surgical
• Female
• Hand (innervation, surgery)
• Humans
• Kidney Failure, Chronic (therapy)
• Male
• Middle Aged
• Muscle Contraction (physiology)
• Myography
• Neuromuscular Blocking Agents
• Renal Dialysis
• Vecuronium Bromide