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British Journal of Anaesthesia, 1989, Vol. 63, No. 4 389-392
© 1989 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

RELATIVE POTENCY OF VECURONIUM ON THE DIAPHRAGM AND THE ADDUCTOR POLLICIS

CLAUDE LEBRAULT, M.D., MARCEL CHAUVIN, M.D., FRÉDÉRIC GUIRIMAND, M.D. and PHILIPPE DUVALDESTIN, M.D.

Department of Anaesthesia, Hôpital Ambroise Paré, Université Paris V 9 Avenue Charles de Gaulle, 92100 Boulogne sur Seine, France

Correspondence to P.D.

To quantify the neuromuscular blocking effect of vecuronium on the diaphragm and the adductor pollicis, single twitch stimuli were applied to the phrenic nerves at the neck and the ulnar nerve at the wrist in anaesthetized patients. The evoked responses were measured simultaneously by recording the transdiaphragmatic pressure with a differential pressure transducer and the adductor pollicis strength with a force displacement transducer. Cumulative vecuronium dose—response curves were determined for both muscles in 11 ASA class I adult patients. The mean (SD) doses required to depress adductor pollicis and diaphragm responses to 50% (ED50) were 30 (9) µg kg–1 and 37 (12) µg kg–1, respectively. Corresponding values for 95% depression of the twitch response (ED95) were 48 (13) µg kg–1 and 67 (23) µg kg–1 (P < 0.02), indicating that the diaphragm required approximately 40% more vecuronium for subtotal abolition of the single twitch response.


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