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Lack of Interaction Between Propofol and Vecuronium

Department of Anaesthetics, The Queen's University of Belfast, Belfast, Northern Ireland and Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan

Abstract

We estimated the potency of vecuronium and measured the onset and duration of its action during total intravenous anesthesia with propofol to examine the possibility of any interaction between these two drugs. Propofol infusion was administered according to a three-step dosage scheme, and neuromuscular block was monitored by measuring the force of contraction of the adductor pollicis muscle after single-twitch stimulation of the ulnar nerve at 0.1 Hz. A control group of patients were similarly studied during anesthesia with thiopental, nitrous oxide, oxygen, and fentanyl. The ED₅₀ and ED₉₅ (dose required to produce a 50% and 95% depression of twitch tension, respectively) of vecuronium in patients given total intravenous anesthesia (n = 24) were 24 (22–27, 95% confidence limits) and 41 (37–48, 95% confidence limits) µg/kg, respectively, and in the control group (n = 24), 20 (17–24) and 39 (34–37) µg/kg, respectively. The onset of action of an 80-µg/kg dose (2 x ED₉₅) of vecuronium was 3.6 ± 1.2 and 4.1 ± 1.7 min (mean ± SD), in the propofol (n = 10) and control (n = 10) groups, respectively. The respective times to recovery of the twitch height to 25% of control and the recovery indices (25%-75% recovery of twitch height) in the propofol versus control groups were 28.3 ± 6.6 and 28.0 ±1.7 min and 13.3 ± 6.8 and 15.4 ± 11.9 min, respectively. There were no significant differences in any of the measured variables between the propofol and control groups, indicating the lack of any interaction between propofol and vecuronium.