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British Journal of Anaesthesia, Vol 83, Issue 2 340-342, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia

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Post-tetanic count and train-of-four responses during neuromuscular block produced by vecuronium and infusion of nicardipine

Y. Saitoh, Y. Narumi and Y. Fujii
Department of Anaesthesiology, Toride Kyodo General Hospital, 2-1-1, Hongo, Toride City, Ibaraki, 302-0022, Japan; Department of Anaesthesiology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan

We have examined onset and recovery of neuromuscular block produced by vecuronium using either post-tetanic count (PTC), or the first twitch of the train-of-four (TOF) (T1/T0) and TOF ratio (T4/T1) during continuous infusion of nicardipine. Sixty adult patients were allocated to one of four groups of 15 patients each: nicardipine-PTC, nicardipine- TOF, control-PTC and control-TOF. In the nicardipine-PTC and nicardipine-TOF groups, nicardipine 0.03 mg kg-1 was given before vecuronium 0.1 mg kg-1 and a continuous infusion of nicardipine was started immediately at a rate of 2 micrograms kg-1 min-1. Mean time from administration of vecuronium to onset of neuromuscular block in the nicardipine-PTC and nicardipine-TOF groups was significantly shorter than in the control-PTC and control-TOF groups (166 (SD 39) vs 220 (28) s; P < 0.05). There was no significant difference in recovery of PTC between the nicardipine-PTC and control-PTC groups or in recovery of TOF ratio in the nicardipine-TOF and control-TOF groups. However, during recovery, T1/T0 in the nicardipine-TOF group was significantly less than that in the control-TOF group, 60-100 min after administration of vecuronium.
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