Effect of low-dose infusion of prostaglandin E1 on vecuronium-induced neuromuscular blockade.

Abstract

The effect of low-dose (20 ng·kg-1·min-1) infusion of prostaglandin E1 (PGE1) on vecuronium-induced neuromuscular blockade was studied. The study population consisted of 24 elderly patients (65-75 years old) and 24 younger adult patients (25-56 years old). They were randomly assigned to the control and PGE1 groups. The steady-state dose requirement (SSDR) of vecuronium was derived from ondemand infusion of the drug which produced a stable twitch height of 20% of its baseline reading, and recovery time after steady-state infusion was defined as the time for recovery from twitch height from 25% to 75%. The patients in the PGE1 group received an infusion of PGE1 20 ng·kg-1·min-1, while those in the control group received an infusion of normal saline. The SSDR (23.2±9.1 and 34.2±5.9 μg·kg-1. hr-1, respectively;P=0.02) was significantly less and the recovery time (35.0±9.5 and 19.9±4.2 min, respectively;P=0.01) was significantly longer in the elderly than in the younger patients. However, low-dose infusion of PGE1 significantly increased the SSDR (23.2±9.1 to 37.4±3.7 μg· kg-1·hr-1;P=0.01) and shortened the recovery time (35.0±9.5 to 23.5±4.0 min;P=0.02) in elderly patients. We concluded that low-dose infusion of PGE1 is effective in preventing the prolonged action of vecuronium in elderly patients.