Experience of multiple supplementary doses of vecuronium. Case report

Area of Science:

• Anesthesiology
• Pharmacology
• Neuromuscular blockade

Background:

• Vecuronium is a neuromuscular blocking agent used in anesthesia.
• Prolonged anesthesia requires careful monitoring of neuromuscular blockade.
• Assessing cumulative effects is crucial for patient safety.

Observation:

• Train-of-four stimulation measured adductor pollicis twitch force.
• Seventy-one supplementary vecuronium doses were administered over 22 hours.
• Isoflurane at 0.5% end-tidal concentration was used.

Findings:

• No cumulative neuromuscular blocking effect of vecuronium was demonstrated under controlled conditions.
• Isoflurane slightly prolonged the neuromuscular blocking effect of vecuronium.
• Vecuronium provided effective muscle relaxation throughout the prolonged procedure.

Implications:

• Vecuronium can be safely used for extended procedures without cumulative effects.
• Anesthetic agents like isoflurane can modulate neuromuscular blockade duration.
• This study supports the predictable use of vecuronium in long surgeries.