The Effect of Lidocaine on the Onset of Vecuronium-Induced Neuromuscular Block

Lee, Younsuk; Chung, Choonkun

Abstract

BACKGROUND: Rapid-sequence induction is common technique to reduce anesthetic complications. Due to side effects of succinylcholine, nondepolarizing muscle relaxants have been tried. The authors tried to observe the effect of lidocaine on the onset of vecuronium.
METHODS
Sixty patients were divided into lidocaine group(L) and control group(C). Anesthetic induction with 4-5 mg/kg of thiopental and 0.1 mg/kg of vecuronium was made. The L-group received 1.5 mg/kg of lidocaine 90 seconds prior to the injection of vecuronium and the C-group received normal saline with the same volume and at the same time like L-group. The ulnar nerve stimulations were applied to detect the contraction of the adductor pollicis on thumb by using Accelograph . The condition of intubation, the appearanee of arrhythmias, side effects of drugs, and the changes of mean arterial pressure and heart rate were checked and compared in peri-induction periods.
RESULTS
The results are followings; (1) There were no differences in changes of MAP and HR, and the appearance of arrhythmias in 2 groups, (2) the conditions of intubation were satisfactory with same degree in 2 groups, (3) ths lidocaine pretreatment decreased significantly the onset of vecuronium (137.5+/-33.4 seconds vs. 176.4+/-62.7 seconds) comparing to the C-group and augumented the potency of vecuronium by 28% CONCLUSIONS : From the above results, the authors concluded that 1.5mg/kg of intravenous lidocaine at 90 seconds before induction can be safely used to reduce the onset time of vecuronium especially in the case of rapid endotracheal intubation. Furthermore, it is expected that lidocaine in combination with other techniques will be more effective in shortening the onset of vecuronium.