Residual Neuromuscular Blockade in Obstetric Patients : Pancuronium vs. Vecuronium
Published Online: Jul 24, 2015
Abstract
Incomplete antagonism of competitive neuromuscular blockade is a potentially lethal complication in postoperative period.
Assessment of recovery from nondepolarizing neuromuscular block has been based on clinical criteria such as; head lift, hand grip strength, adequate tidal volume, vital capscity and inspiratory force which mostly require a cooperative patient. Other criteria, indepent of patient cooperation have been the interpretation of evoked muscle responses to single twich, tetanic and train-of-four stimulation.
The present prospective investigation compare the incidence of residual neuromuscular blockade using train-of-four responses following administration and reversal of pancuronium and vecuronium in obstetric patients.
The results were as follows:
1) The mean TOF ratio(T4/T1) in pancuronium group was 0.75±0.05.
2) The mean TOF ratio(T4/T1) in vecuronium group was 0.85±0.04.
3) 50% of patients(10/20) in the pancuronium group evidenced a ratio below 0.7, 20% of patients(4/20) in the vecuronium group was evidenced a TOF ratio below 0.7.
In conclusion, the present study emphasizes the potential for residual neuromuscular blockade in patients who received pancuronium. In contrast, patients administered vecuronium appear to have a grater margin of safty postoperatively.
