Korean J Anesthesiol.  1999 Nov;37(5):763-768. 10.4097/kjae.1999.37.5.763.

Effect of Additional Lidocaine on the Onset Time of Vecuronium

• Kim TY
• Seong KW
• Yang JS

• KMID: 2239008
• DOI: http://doi.org/10.4097/kjae.1999.37.5.763

Abstract

BACKGROUND: Local anesthetics have been shown to interact with neuromuscular blockers. Most local anesthetics decrease neuromuscular transmission and potentiate neuromuscular block from muscle relaxants. The purpose of this study was to examine the effectiveness of lidocaine on the onset time of vecuronium and to compare that with other method such as simply increasing the dose of vecuronium.
METHODS
Sixty patients of ASA physical status I or II were induced with thiopental (4-5 mg/kg) and maintained with O2-enflurane (2.5 vol%). They were randomly divided into four groups: Vecuronium (0.1 mg/kg) was administered intravenously in Group C (n = 15), additional lidocaine (1 mg/kg) was given intravenously 1 min prior to administration of vecuronium in Group L (n = 15), increased vecuronium (0.15 mg/kg) was given in Group V (n = 15) and succinylcholine was given in Group S (n = 15), respectively. Neuromuscular blockade was assessed by train-of-four (TOF) at the adductor pollicis muscle with supramaximal stimulation of ulnar nerve (2 Hz, 0.2 ms) every 12 sec. Endotracheal intubation was performed and intubating conditions were evaluated according to the standard scoring method after measuring the onset time (from the end of giving each muscle relaxants to the 90% suppression of the first twitch).
RESULTS
The onset time of Group L (122.0+/-11.0 sec) and that of Group V (98.0+/-16.9 sec) were shorter than that of Group C (135.2+/-16.0 sec) (P<0.05), but these were not shorter than that of Group S (42.0+/-6.2 sec). There was no statistical difference between Group L and Group V. Intubating conditions were good or excellent in all groups.
CONCLUSIONS
Additional lidocaine for attenuating sympathetic response could accelerate the onset of vecuronium. But the onset time of this method was not shorter than that of simply increasing the dose of vecuroium nor that of succinylcholine.

Keyword

Anesthetics, local, lidocaine; Pharmacodynamics, onset time; Neuromuscular relaxants, vecuronium, succinylcholine

MeSH Terms

Anesthetics, Local
Humans
Intubation, Intratracheal
Lidocaine*
Neuromuscular Blockade
Neuromuscular Blocking Agents
Research Design
Succinylcholine
Thiopental
Ulnar Nerve
Vecuronium Bromide*
Anesthetics, Local
Lidocaine
Neuromuscular Blocking Agents
Succinylcholine
Thiopental
Vecuronium Bromide