Acute desflurane or sevoflurane exposure on a previously stabilized atracurium-induced neuromuscular block.

Abstract:

BACKGROUND AND OBJECTIVE:The aim of this prospective study was to compare the effect of the administration of desflurane or sevoflurane to a fixed neuromuscular block. METHODS:After written consent, 12 patients were anaesthetized with propofol and sufentanil. Atracurium was administered via a continuous infusion in order to obtain 85% twitch depression of the control value assessed by repeated accelerometric stimulation at the adductor pollicis. Once stabilized over the course of 30 min, propofol was discontinued and either desflurane (n = 6) or sevoflurane (n = 6) was delivered at 1 MAC in a mixture of 50% O(2) in air. Study parameters were the magnitude and the time of twitch height variations. Results are presented in mean +/- SD. RESULT:Exposure to halogenated agents led to a significant reduction in twitch height with similar magnitude between the two agents. However, interaction with desflurane showed an initial and transient rise (35 +/- 22%) in twitch height before subsequent depression occurred. The time to reach 50% of the signal depression in the desflurane group was significantly delayed (25 +/- 7 vs. 11 +/- 4 min in the sevoflurane group; P < 0.01). CONCLUSIONS:On a stable neuromuscular block elicited by continuous infusion of atracurium, the abrupt administration of desflurane or sevoflurane reduces the accelerometric responses of the adductor pollicis in a similar way. This potentiating effect is produced faster after sevoflurane than after desflurane. With desflurane, a biphasic effect (of a transient and moderate increase followed by depression of the signal) was recorded.

journal_name

Eur J Anaesthesiol

authors

Beaussier M,Boughaba A,Schiffer E,Debaene B,Lienhart A,d'Hollander A

doi

10.1017/S0265021506000706

subject

Has Abstract

pub_date

2006-09-01 00:00:00

pages

755-9

issue

9

eissn

0265-0215

issn

1365-2346

pii

S0265021506000706

journal_volume

23

pub_type

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