Distribution, elimination, and action of vecuronium in the elderly

C. A. Lien, R. S. Matteo, E. Ornstein, A. E. Schwartz, J. Diaz

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

The effects of age on the pharmacokinetics and pharmacodynamics of vecuronium in eight elderly patients aged 72-86 yr and eight younger adults aged 26-48 yr undergoing elective surgical procedures under nitrous oxide-fentanyl anesthesia were studied. Vecuronium (0.1 mg/kg) was given as an intravenous bolus, and the ulnar nerve was stimulated with a square-wave impulse of 0.2-ms duration. The response to stimulation at a frequency of 0.1 Hz was measured and recorded with a force displacement transducer applied to the thumb. Spontaneous recovery was significantly longer in elderly patients than in younger patients (50% recovery time, 97.1 ± 29 vs 39.8 ± 14 min, mean ± SD; recovery index [25%-75%], 49.4 ± 11 vs 15.0 ± 8 min). In addition, in elderly patients elimination half-life of vecuronium was significantly prolonged (125 ± 55 vs 78 ± 21 min, P = 0.04) and plasma clearance reduced (2.6 ± 0.6 vs 5.6 ± 3.2 mL · kg-1 · min-1, P = 0.049). The prolonged duration of action of vecuronium in the elderly surgical patients thus appears to be secondary to altered pharmacokinetics consistent with an age-related decrease in renal and hepatic functions.

Original languageEnglish
Pages (from-to)39-42
Number of pages4
JournalAnesthesia and Analgesia
Volume73
Issue number1
DOIs
StatePublished - 1991
Externally publishedYes

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