High concentration sevoflurane induction of anesthesia accelerates onset of vecuronium neuromuscular blockade

Yamaguchi, Shigeki; Egawa, Hirotoshi; Okuda, Keiko; Mishio, M; Okuda, Yasuhisa; Kitajima, Toshimitsu

doi:10.1007/bf03019811

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…Ahmed et al [ 17 ] also reported that an increase in sevoflurane exposure time did not shorten the time to maximum block. However, Yamaguchi et al [ 18 ] reported that 8 % sevoflurane induction accelerates the onset of the vecuronium neuromuscular blockade. They found that the maximum block in the 8 % sevoflurane group was shorter than that in the propofol/fentanyl group and the N 2 O/2 % sevoflurane group (139 ± 35 s, 193 ± 35 s, and 188 ± 47 s, respectively).…”

Section: Discussionmentioning

confidence: 99%

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

Lee

Koh

et al. 2015

BMC Anesthesiol

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BackgroundWe conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population.MethodsA total of 368 ASA I–II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0.3, 0.6, or 0.9 mg/kg and then intubation condition was evaluated. The time to maximum block and recovery profile were monitored by TOF stimulation of the ulnar nerve and by recording the adductor pollicis response using acceleromyography.ResultsThe numbers of patients with clinically acceptable intubation conditions were 41, 82, and 97 % (TIVA) and 34, 85, and 90 % (SEVO) at each dose of rocuronium, respectively. There were no significant differences in the time to maximum block between groups at each rocuronium dose. There were significant differences in the recovery to a train-of-four ratio of 90 % between the groups: 42.7 (19.5), 74.8 (29.9), and 118.4 (35.1) min (TIVA) and 66.5 (39.3), 110.2 (43.5), and 144.4 (57.5) min (SEVO) at 0.3, 0.6, and 0.9 mg/kg, respectively (P < 0.001).ConclusionsThere are no significant differences in intubation conditions between propofol-remifentanil and sevoflurane-remifentanil anesthesia at the same dose of rocuronium. The type of anesthetic does not significantly influence the time to maximum block by rocuronium. Rocuronium at a dose of 0.9 mg/kg should be used for better intubation conditions with both anesthesia regimens in an Asian population.Trial registrationUMIN-CTR Clinical Trial (http://www.umin.ac.jp/ctr/index.htm; UMIN#000007289; date of registration 14th February 2012).

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Section: Discussionmentioning

confidence: 99%

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

Lee

Koh

et al. 2015

BMC Anesthesiol

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“…The effects of sevoflurane on the onset of neuromuscularblocking drugs have been studied only at adductor pollicis muscles. Yamaguchi et al evaluated the effects of inhalation of sevoflurane as an induction agent on the onset time of neuromuscular-blocking drugs [9]. They reported that induction with 8% sevoflurane accelerated the onset time of 0.1 mg kg −1 vecuronium compared with induction with propofol [9].…”

Section: Discussionmentioning

confidence: 99%

“…Yamaguchi et al evaluated the effects of inhalation of sevoflurane as an induction agent on the onset time of neuromuscular-blocking drugs [9]. They reported that induction with 8% sevoflurane accelerated the onset time of 0.1 mg kg −1 vecuronium compared with induction with propofol [9]. Conversely, using intravenous agents for the induction of general anesthesia, several authors reported that the onset time of nondepolarizing neuromuscular-blocking drugs was not shortened by sevoflurane at concentrations <2%.…”

Section: Discussionmentioning

confidence: 99%

“…Inhalational anesthetics (including sevoflurane) increase the intensity and duration of nondepolarizing neuromuscularblocking drugs [4][5][6][7][8]. It has been reported that the induction of general anesthesia with sevoflurane shortens the onset time of vecuronium at the adductor pollicis muscles [9]. However, during the induction of general anesthesia, it is important to know the degree of neuromuscular blockade at the laryngeal muscles.…”

Section: Introductionmentioning

confidence: 99%

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Sevoflurane Induction Shortens the Onset of Vecuronium at the Corrugator Supercilii Muscles: A Randomized Comparison with Propofol Induction

Nitahara

Sugi

Kusumoto

et al. 2011

ISRN Anesthesiology

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We evaluated if induction with sevoflurane shortened the onset of vecuronium-induced neuromuscular blockade at the corrugator supercilii muscles (which have a similar time course of neuromuscular blockade with laryngeal muscles). Thirty-two patients were randomly allocated to a sevoflurane or propofol group. Anesthesia was induced with 5% sevoflurane in oxygen (sevoflurane group, n=16) or with propofol 2–2.5 mg kg−1(propofol group, n=16), and vecuronium (0.1 mg kg−1) was given in both groups. Evoked responses to train-of-four stimuli were measured by acceleromyography at the corrugator supercilii and adductor pollicis muscles. Sevoflurane induction, as compared with propofol, significantly shortened the onset time at the corrugator supercilii muscles from 138 ± 34 s to 107 ± 28 s (P<0.01). Onset time at the corrugator supercilii was significantly shorter than at the adductor pollicis for both groups (P<0.01). Our results suggest that induction with sevoflurane, as compared with propofol, shortened the onset time of vecuronium at laryngeal muscles.

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“…[1][2][3][4][5] Compared to the conventional inhalation induction technique using a gradual increase of concentration, a high concentration sevoflurane induction produced a rapid induction and reduced adverse effects. 4 Furthermore, sevoflurane induction provided additional advantages such as good cardiovascular stability, 3,6,7 smooth transition between induction and maintenance, 6,8 and rapid onset of non-depolarizing muscle relaxant 9 compared with iv induction.…”

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confidence: 99%

L’induction de l’anesthésie au sévoflurane, avec une réduction graduelle de la concentration, est bien tolérée par les patients âgés

Yamaguchi

Ikeda

Wake

et al. 2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To establish the appropriate inhalation induction technique using a high concentration of sevoflurane in the elderly.M Me et th ho od ds s: : Forty-five patients, aged 70-79-yr-old, were randomly divided into three groups: 1) Group I: anesthesia was induced with propofol 2 mg·kg -1 and sevoflurane 2% (n = 15); 2) Group II: anesthesia was induced with a three-minute inhalation of sevoflurane 8%; 3) Group III: anesthesia was induced with inhalation of sevoflurane using a gradual reduction technique (8, 6, 4% for each minute). In Groups II and III, a modified vital capacity inhalation induction was performed. Mean arterial pressure (MAP), heart rate (HR) and oxygen saturation (SpO 2 ) were measured continuously during induction. In addition, induction time and adverse events related to anesthetic induction were recorded. R Re es su ul lt ts s: : The induction time in Group I was significantly shorter than that in Groups II and III (P < 0.05). However, there was no difference in the induction time between Groups II and III. In Groups II and III, the majority of patients required additional breaths. In comparison with the other groups, stability of MAP was maintained in Group III. The variations of HR in all groups were small. During induction, no patient experienced a decrease in SpO 2 below 96%, except for two patients in Group I. Severe respiratory adverse events were not observed. Other adverse events were similar in all groups.C Co on nc cl lu us si io on ns s: : Our results suggest that a high concentration sevoflurane induction using a gradual reduction technique may be an acceptable alternative to standard iv induction in elderly patients. II et III (P < 0,05 Objectif : Réaliser la technique appropriée d'induction par inhalation en utilisant une forte concentration de sévoflurane chez des patients âgés. Méthode : Quarante-cinq patients de 70-79 ans, ont été répartis de façon aléatoire en trois groupes : 1) groupe I : anesthésie induite avec 2 mg·kg -1 de propofol et du sévoflurane à 2 % (n = 15) ; 2) groupe II : anesthésie induite avec l'inhalation de sévoflurane à 8 % pendant 3 min ; 3) groupe III : anesthésie induite avec l'inhalation de sévoflurane selon la technique de réduction graduelle de la concentration (8, 6, 4 % pour chaque minute). Dans les groupes II et III, une induction par inhalation, avec modification de la capacité vitale, a été réalisée. La tension artérielle moyenne (TAM), la fréquence cardiaque (FR) et la saturation du sang en oxygène (SpO 2 ) ont été mesurées en continu pendant l'induction. De plus, le temps nécessaire à l'induction et les événements indésirables reliés à l'induction anesthésique ont été notés. Résultats : Le temps d'induction a été significativement plus court dans le groupe I que dans les groupes

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High concentration sevoflurane induction of anesthesia accelerates onset of vecuronium neuromuscular blockade

Abstract: 34GENERAL ANESTHESIA Purpose: To investigate neuromuscular block using accelography after administration of vecuronium under sevoflurane 8% induction and maintenance with sevoflurane 2% in adults.

Cited by 8 publications

References 18 publications

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population

Sevoflurane Induction Shortens the Onset of Vecuronium at the Corrugator Supercilii Muscles: A Randomized Comparison with Propofol Induction

L’induction de l’anesthésie au sévoflurane, avec une réduction graduelle de la concentration, est bien tolérée par les patients âgés

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