British Journal of Anaesthesia, 2003, Vol. 90, No. 4 480-486
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Clinical Investigations |
Monitoring of neuromuscular block after administration of vecuronium in patients with diabetes mellitus
1 Department of Anesthesiology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima-City, Fukushima 960-1295, Japan. 2 Department of Anesthesiology, Toride Kyodo General Hospital, Ibaraki, Japan
Corresponding author. E-mail: ys@m6.people.or.jp
Background. We studied the supramaximal current for ulnar nerve stimulation during electromyographic monitoring of onset and recovery of neuromuscular block using a neuromuscular transmission module (M-NMT Module, Datex-Ohmeda) in patients with Type 2 diabetes undergoing anaesthesia with nitrous oxide, oxygen, isoflurane and fentanyl.
Methods. Thirty-six diabetic patients were randomly assigned to a post-tetanic count (PTC) group (n=17) or train-of-four (TOF) group (n=19). In addition, 30 non-diabetic patients were divided into control PTC (n=15) and TOF groups (n=15).
Results. In the diabetic patients (diabetes PTC and diabetes TOF groups), the mean supramaximal stimulating current was significantly higher than in the non-diabetic patients (control PTC and TOF groups) (50.5 (SD 14.1) vs 33.4 (6.1) mA, P<0.01). Onset of neuromuscular block (time to disappearance of T1) after vecuronium 0.1 mg kg–1 in the diabetic patients did not differ significantly from that in the non-diabetic patients (276 (77) vs 244 (44) s, P=0.055). Time to return of PTC1 did not differ significantly between the diabetes and control PTC groups (21.0 (12.1) vs 15.7 (5.0) min, P=0.126). Times to return of T1 and T4 in the diabetes TOF group were significantly longer than in the control TOF group (T1: 37.5 (15.2) vs 25.7 (7.6) min, P=0.01; T4: 61.4 (23.7) vs 43.5 (11.4) min, P=0.01). During recovery, PTC and T4/T1 in the diabetes PTC and TOF groups were similar to those in the control PTC and TOF groups, respectively. T1/T0 in the diabetes TOF group was significantly less than in the control TOF group, 80–120 min after vecuronium (P<0.05).
Conclusions. In diabetic patients, supramaximal current is higher than in non-diabetic patients. After vecuronium, onset of neuromuscular block and recovery of PTC or T4/T1 are not altered, but time to return of T1 or T4, and recovery of T1/T0 are delayed in diabetic patients.
Br J Anaesth 2003; 90: 480–6
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Y. Saitoh Recovery from vecuronium is delayed in patients with hypercholesterolemia: [La recuperation d'un bloc au vecuronium est retardee en cas d'hypercholesterolemie]. Can J Anesth, June 1, 2006; 53(6): 556 - 561. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Saitoh, H. Hattori, N. Sanbe, H. Nakajima, M. Akatu, and M. Murakawa Delayed recovery of vecuronium neuromuscular block in diabetic patients during sevoflurane anesthesia: [Bloc neuromusculaire au vecuronium prolonge chez des patients diabetiques pendant l'anesthesie au sevoflurane] Can J Anesth, May 1, 2005; 52(5): 467 - 473. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. M. Hemmerling, G. Michaud, S. Deschamps, G. Trager, and Y. Saitoh Monitoring neuromuscular blockade in diabetic patients using electromyography: an opportunity missed Br. J. Anaesth., October 1, 2003; 91(4): 608 - 609. [Full Text] [PDF]
|
|