Effect of diabetes mellitus on cisatracurium-induced neuromuscular block when combined with sevoflurane anesthesia

Abstract

Objective To evaluate the effect of diabetes mellitus (DM) on cisatracurium-induced neuromuscular block when combined with sevoflurane anesthesia.Methods Thirty patients of both sexes,aged 30-60 yr,with body mass index of 18-25 kg/m2,scheduled for elective endoscopic sinus surgery,of ASA physical status Ⅰ or Ⅱ,were included in the study.The patients with type 2 DM and course of disease ＞ 3 yr served as DM group (n =15).Another 15 non-diabetic patients were included in thisstudy as control group (n =15).Neuromuscular block was monitored with TOF-Watch(R) SX Monitor.The response of the adductor pollicis to TOF stimulation of the ulnar nerve was recorded after loss of consciousness.Anesthesia was induced with iv midazolam 0.05-0.10 mg/kg,fentanyl 3-5 tg/kg and propofol 1-2 mg/kg,and maintained with inhalation of.sevoflurane (endtidal concentration of 2 ％) and infusion of remifentanil 0.1-0.3μg· kg-1 · min-1.No response time (duration of T1 =0),clinical duration (time from end of injection to 25 ％ recovery of T1),and recovery index (T1 from 25 ％-75 ％) were recorded.Results Compared with C group,no response time,clinical duration,and recovery index were prolonged in DM group.Conclusion DM can prolong the duration of action of cisatracurium when combined with sevoflurane anesthesia and inhibit the recovery of neuromuscular block. Key words: Diabetes mellitus; Atracurium; Neuromuscular blockade; Anesthetics,inhalation