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DOES A SUBPARALYSING DOSE OF VECURONIUM ENHANCE DIAPHRAGM FATIGUE? |
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| Authors: | DUREUIL, B. LEBRAULT, C. BOCZKOWSKI, J. AUBIER, M. DUVALDESTIN, P. |
| Affiliation: | Department of Anaesthesia, Hôpital Bichat, Université Paris 7, 75018 Paris Department of Respiratory Physiology, Hôpital Bichat, Université Paris 7, 75018 Paris Department of Anesthesia, Hôpital Ambroise Paré, Université Paris 5, 92104 Boulogne Clinique Pneumologique, INSERM Unite 226, Hfipital Beaujon, Universite Paris 7, 92110 Clichy Department of Anesthesia, Hôpital Henri Mondor, Université Paris 12, 94010 Creteil, France |
| Abstract: | We have examined, in six healthy volunteers, the effect of asubparalysing dose of vecuronium on the development of diaphragmfatigue. Vecuronium was given as a 0.5-mg bolus i.v. followedby 0.5 mg infused over 30 min; as a control, saline was givenin random order. Diaphragm strength was assessed by measuringtransdiaphragm pressure and by electromyography. Diaphragm fatiguewas induced by breathing against an inspirator resistance. Theplasma concentration of vecuronium varied between 15 and30 ngml1 15 min after administration of vecuronium was started.Peripheral neuromuscular block was not detected in any subject.Diaphragm fatigue developed within the same period in both groups:mean 334 (SD 166) s after saline and 345 (190) s after vecuronium.The electromyographic pattern of diaphragm fatigue and the timeconstant of relaxation of transdiaphragm pressure after fatiguewere similar in both groups. We conclude that, at low plasmaconcentrations of vecuronium, similar to those present in thepostoperative period, there was no predisposition to diaphragmfatigue. |
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