Changes in the plasma histamine concentration after the administration of vecuronium bromide

Abstract

Clinical symptoms of anaphylactoid reaction to muscle relaxants vary from localized flush to cardiovascular collapse. Vecuronium bromide is reported to have very little histamine releasing property. However, there are some reports of anaphylaxis or anaphylactoid reaction to vecuronium. We studied plasma histamine concentration after the intravenous injection of vecuronium to confirm the histamine release. Twenty patients were randomly allocated to one of two groups, each group comprising of 10 patients: one group was to receive vecuronium 0.1 mg.kg(-1) and the other 0.2 mg.kg(-1) using the priming principle. Blood samples were taken prior to and 1, 3, 5, 8 and 13 min after the administration of vecuronium. The plasma histamine concentration was measured by radioimmunoassay with monoclonal antibody. There were no significant changes in plasma histamine concentration over 13 min after the administration of vecuronium compared with the baseline value. There were also no significant differences between these two groups. We concluded that vecuronium up to 0.2 mg.kg(-1) did not change the plasma histamine concentration in the patients having no previous history of allergy or atopic tendencies.

Total intravenous anesthesia combined with epidural eptazocine

“…No significant depression of respiration by ketamine [22,23], diazepam [23], droperidol [24] and eptazocine [25] in the respective clinical doses has been demonstrated. In addition, ketamine [26][27][28][29], opioids [5,30], diazepam [31], droperidol [24], and vecuronium [32] have been shown not to stimulate bronchial smooth muscle in the clinical doses used in this study, and this accounts for the lack of significant effects on respiration of our TIVA regime. In fact, a 72-yearold woman with a recent history of several complicated asthmatic attacks underwent uneventful subtotal gastrectomy under TIVA plus epidural eptazocine.…”