The influence of acute normovolemic hemodilution on the dose-response and time course of action of vecuronium

Anesthesia and Analgesia
F S XueL K Luo

Abstract

To evaluate the influence of acute isovolemic hemodilution on the dose-response and time course of action of vecuronium, we studied 60 adult patients with and without hemodilution during surgery. The patients with hemodilution underwent major elective plastic surgery with an anticipated surgical loss of more than 600 mL. Anesthesia was induced with thiopental 4-6 mg/kg and fentanyl 2-4 microg/kg i.v. and was maintained with 60% nitrous oxide in oxygen. Further increments of thiopental 2 mg/kg or fentanyl 2 microg/kg were given as required. Acute isovolemic hemodilution in the hemodilution group was induced by drainage of venous blood and an i.v. infusion of lactated Ringer's solution and 6% dextran, during which hematocrit and hemoglobin decreased from 45.7% to 26.2% and from 148.5 g/L to 90.2 g/L, respectively. Neuromuscular function was assessed mechanomyographically with train-of-four stimulation at the wrist every 12 s, and the percent depression of T1 response was used as the study parameter. The dose-response relationships of vecuronium in the two groups were determined by using the cumulative dose-response technique. The results showed that during hemodilution, the dose-response curve of vecuronium was shifted to the lef...Continue Reading

References

Sep 1, 1975·Journal of Applied Physiology·N O Fowler, J C Holmes
May 1, 1992·Acta Anaesthesiologica Scandinavica·G McCarthyR S Clarke
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Mar 1, 1981·British Journal of Anaesthesia·F T Schuh
Jan 10, 1998·British Journal of Anaesthesia·F S XueL K Luo

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Citations

Jul 19, 2008·Anesthesia and Analgesia·Philippe DulvadestinJean Marty
Jul 29, 2008·Current Opinion in Anaesthesiology·Leo H D J Booij
Jun 30, 2005·Der Anaesthesist·T MenckeH Rensing

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