C. J. Ferres

Pretreatment With Vecuronium as a Prophylactic Against Post-Suxamethonium Muscle Pain

One hundred and ninety-eight patients undergoing minor surgery were assessed for evidence of post-suxamethonium muscle pain on the 1st and 2nd days following surgery. Patients were allocated to nine groups and were given one of four non-depolarizing neuromuscular blocking drugs (vecuronium, gallamine, tubocurarine or pancuronium) 1 or 2 min before the administration of suxamethonium. A control group received an inert medication. Forty-one per cent of patients receiving no pretreatment experienced muscle pain. This frequency was decreased to around 20% following pretreatment. In general, the frequency of pain was less in the groups receiving pretreatment at 1 min, but the difference was not significant. The groups receiving vecuronium before suxamethonium had the lowest overall frequency of pain over the 2 days (19%), although this was not significantly different from other pretreatments.

An evaluation of Org NC 45 (vecuronium) in paediatric anaesthesia.

Vecuronium (Org NC 45) was evaluated as a neuromuscular blocking agent in chidren and compared with pancuronium in a double‐blind study. Satisfactory intubating conditions were present 90 seconds after 0.1 mg/kg of either drug. The onset of complete block was quicker after vecuronium but the greatest difference was found in the duration to 25% recovery which was significantly shorter with vecuronium (20 min) compared with pancuronium (48 min). The use of vecuronium was associated with cardiovascular stability and no clinical evidence of histamine release. Antagonism of the block was readily achieved with neostigmine.

Time course of action of combinations of vecuronium and pancuronium

Vecuronium 0.1 mg/kg, puncuronium 0.1 mg/kg, vecuronium 0.075 mg/kg t pancuronium 0.025 mg/kg, vecuronium + pancuronium 0.05 mg/kg each and vecuronium 0.025 mg/kg + pancuronium 0.075 mg/kg were compared with respect to time tuken to onset oj effect, duration of clinical relaxation and intubation conditions in jive groups of 20 patients each. Thi. time to onset and intubating conditions were similar in all thc groups. indicating that the combinations have no advantage over the individual drugs. The duration of clinicul relaxation was 25 minutes with vecuronium, and increased as the proportion of pancuronium in the niixturc increased, being 56 minutes with pancuronium 0.I mg/kg.

Clinical Evaluation of Org NC 45

Org NC 45, a new non-depolarizing neuromuscular blocking drug, was evaluated in 200 adult patients. The drug was administered in doses of 0.1, 0.15 or 0.2 mg kg-1. Intubation could be satisfactorily carried out at around 90 s in 90% of patients. The duration of clinical relaxation varied from 23 min with 0.1 mg kg-1 and neuroleptanaesthesia to 71 min with 0.2 mg kg-1 and anaesthesia with halothane or enflurane. The duration of clinical relaxation following repeated administration of 2-3 mg was remarkably constant (between 17 and 20 min) thus showing lack of cumulation. The antagonism of residual block was prompt and easy following administration of neostigmine, and the drug lacked any significant cardiovascular effects as seen by routine monitoring.