Abstract
We evaluated if induction with sevoflurane shortened the onset of vecuronium-induced neuromuscular blockade at the corrugator supercilii muscles (which have a similar time course of neuromuscular blockade with laryngeal muscles). Thirty-two patients were randomly allocated to a sevoflurane or propofol group. Anesthesia was induced with 5% sevoflurane in oxygen (sevoflurane group,n=16) or with propofol 2–2.5 mg kg−1(propofol group,n=16), and vecuronium (0.1 mg kg−1) was given in both groups. Evoked responses to train-of-four stimuli were measured by acceleromyography at the corrugator supercilii and adductor pollicis muscles. Sevoflurane induction, as compared with propofol, significantly shortened the onset time at the corrugator supercilii muscles from 138 ± 34 s to 107 ± 28 s (P<0.01). Onset time at the corrugator supercilii was significantly shorter than at the adductor pollicis for both groups (P<0.01). Our results suggest that induction with sevoflurane, as compared with propofol, shortened the onset time of vecuronium at laryngeal muscles.
Highlights
Induction and maintenance of anesthesia with sevoflurane has been used in adults owing to its low solubility and nonirritant properties upon the respiratory tract [1,2,3]
Compared with the propofol group, the sevoflurane group had a shorter onset time and a delayed recovery of neuromuscular blockade induced by vecuronium at the corrugator supercilii and adductor pollicis muscles
We measured neuromuscular blockade at these two muscles because (i) the time course of neuromuscular blockade at the corrugator supercilii muscles is similar to that at laryngeal muscles and (ii) the adductor pollicis is a useful and convenient site for anesthesiologists to monitor the effects of neuromuscularblocking drugs [10]
Summary
Induction and maintenance of anesthesia with sevoflurane has been used in adults owing to its low solubility and nonirritant properties upon the respiratory tract [1,2,3]. Inhalational anesthetics (including sevoflurane) increase the intensity and duration of nondepolarizing neuromuscularblocking drugs [4,5,6,7,8]. It has been reported that the induction of general anesthesia with sevoflurane shortens the onset time of vecuronium at the adductor pollicis muscles [9]. During the induction of general anesthesia, it is important to know the degree of neuromuscular blockade at the laryngeal muscles. Studies that have evaluated the effects of sevoflurane induction on the onset of nondepolarizing neuromuscularblocking drugs at the laryngeal muscles (or other muscles having similar neuromuscular blocking profiles to the laryngeal muscles) are lacking. It has been reported that the time course of neuromuscular blockade at the corrugator supercilii muscle is similar to that at the laryngeal muscles [10]
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