Ewha Med J.  1991 Dec;14(4):437-441. 10.12771/emj.1991.14.4.437.

Residual Neuromuscular Blockade in Obstetric Patients : Pancuronium vs. Vecuronium

• Lee GY

• KMID: 2170875
• DOI: http://doi.org/10.12771/emj.1991.14.4.437

Abstract

Incomplete antagonism of competitive neuromuscular blockade is a potentially lethal complication in postoperative period. Assessment of recovery from nondepolarizing neuromuscular block has been based on clinical criteria such as; head lift, hand grip strength, adequate tidal volume, vital capscity and inspiratory force which mostly require a cooperative patient. Other criteria, indepent of patient cooperation have been the interpretation of evoked muscle responses to single twich, tetanic and train-of-four stimulation. The present prospective investigation compare the incidence of residual neuromuscular blockade using train-of-four responses following administration and reversal of pancuronium and vecuronium in obstetric patients. The results were as follows: 1) The mean TOF ratio(T4/T1) in pancuronium group was 0.75+/-0.05. 2) The mean TOF ratio(T4/T1) in vecuronium group was 0.85+/-0.04. 3) 50% of patients(10/20) in the pancuronium group evidenced a ratio below 0.7, 20% of patients(4/20) in the vecuronium group was evidenced a TOF ratio below 0.7. In conclusion, the present study emphasizes the potential for residual neuromuscular blockade in patients who received pancuronium. In contrast, patients administered vecuronium appear to have a grater margin of safty postoperatively.

MeSH Terms

Hand
Hand Strength
Head
Humans
Incidence
Neuromuscular Blockade*
Pancuronium*
Patient Compliance
Postoperative Period
Prospective Studies
Tidal Volume
Vecuronium Bromide*
Pancuronium
Vecuronium Bromide