Recovery from vecuronium is delayed in patients with hypercholesterolemia

Abstract

To examine the effects of hypercholesterolemia with respect to onset time and recovery from vecuronium-induced neuromuscular block. A randomized controlled trial was undertaken in 20 adult patients with hypercholesterolemia (hypercholesterolemia group) and 20 healthy patients with normal serum cholesterolemia (control group). Following induction of anesthesia, vecuronium 0.1 mg.kg(-1) iv was administered. Onset of neuromuscular block and recovery times in the two groups were compared using supramaximal stimulation of the ulnar nerve. The supramaximal stimulating current in the hypercholesterolemia group was similar to that of the control group (38.1 +/- 15.5 vs 31.3 +/- 7.6 mA, P = 0.087). Onset of vecuronium-induced neuromuscular block (time to loss of response to T1) in the hypercholesterolemia group was similar to that observed in the control group (243 +/- 84 vs 249 +/- 56 sec, P = 0.792). Times from vecuronium administration to the return of T1 were also similar in the two groups (29.8 +/- 9.7 vs 25.3 +/- 6.8 min, P = 0.099). However, mean times for return of T2, T3, and T4 in the hypercholesterolemia group were longer than in the control group (44.5 +/- 14.4 vs 34.0 +/- 8.4 min for T2, P = 0.018). During recovery from neuromuscular block, T1/control and train-of-four ratio in the hypercholesterolemia group were less than in the control group, 90-120 min and 70-120 min after vecuronium, respectively (P < 0.05). Recovery from vecuronium-induced neuromuscular block is delayed in patients with hypercholesterolemia.