Sensitivity to vecuronium in myasthenia gravis: a dose-response study

James B. Eisenkraft; W. Jeffrey Book; Angelos E. Papatestas

doi:10.1007/BF03005579

Sensitivity to vecuronium in myasthenia gravis: a dose-response study

James B. Eisenkraft, W. Jeffrey Book, Angelos E. Papatestas

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Abstract

A cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle were used to determine the potency of vecuronium in 20 normal patients and in ten patients with myasthenia gravis under thiamylal, N₂O, O₂, fentanyl anaesthesia. The mean (± SEM) values for ED₅₀, ED₉₀, and ED₉₅ in the normal patients were 19 ± 1, 31 ± 1 and 36 ± 2 μg · kg^{- 1}, respectively. Myasthenic patients showed increased sensitivity to vecuronium, the mean values for ED₅₀, ED₉₀, and ED₉₅ were 10 ± 2, 17 ± 2 and 20 ± 3 μg · kg^{- 1}, being50, 55 and 56 per cent of normal, respectively. We did not demonstrate a difference in sensitivity to vecuronium between those myasthenic patients who received pyridostigmine preoperatively and those who did not, nor among those chronically treated with corticosteroids, compared with those who were not.

Original language	English
Pages (from-to)	301-306
Number of pages	6
Journal	Canadian Journal of Anaesthesia
Volume	37
Issue number	3
DOIs	https://doi.org/10.1007/BF03005579
State	Published - Apr 1990

Keywords

complications: myasthenia gravis
measurement techniques: electromyography, neuromuscular blockade
neuromuscular relaxants: vecuronium

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title = "Sensitivity to vecuronium in myasthenia gravis: a dose-response study",

abstract = "A cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle were used to determine the potency of vecuronium in 20 normal patients and in ten patients with myasthenia gravis under thiamylal, N2O, O2, fentanyl anaesthesia. The mean (± SEM) values for ED50, ED90, and ED95 in the normal patients were 19 ± 1, 31 ± 1 and 36 ± 2 μg · kg- 1, respectively. Myasthenic patients showed increased sensitivity to vecuronium, the mean values for ED50, ED90, and ED95 were 10 ± 2, 17 ± 2 and 20 ± 3 μg · kg- 1, being50, 55 and 56 per cent of normal, respectively. We did not demonstrate a difference in sensitivity to vecuronium between those myasthenic patients who received pyridostigmine preoperatively and those who did not, nor among those chronically treated with corticosteroids, compared with those who were not.",

keywords = "complications: myasthenia gravis, measurement techniques: electromyography, neuromuscular blockade, neuromuscular relaxants: vecuronium",

author = "Eisenkraft, {James B.} and Book, {W. Jeffrey} and Papatestas, {Angelos E.}",

year = "1990",

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doi = "10.1007/BF03005579",

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T1 - Sensitivity to vecuronium in myasthenia gravis

T2 - a dose-response study

AU - Eisenkraft, James B.

AU - Book, W. Jeffrey

AU - Papatestas, Angelos E.

PY - 1990/4

Y1 - 1990/4

N2 - A cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle were used to determine the potency of vecuronium in 20 normal patients and in ten patients with myasthenia gravis under thiamylal, N2O, O2, fentanyl anaesthesia. The mean (± SEM) values for ED50, ED90, and ED95 in the normal patients were 19 ± 1, 31 ± 1 and 36 ± 2 μg · kg- 1, respectively. Myasthenic patients showed increased sensitivity to vecuronium, the mean values for ED50, ED90, and ED95 were 10 ± 2, 17 ± 2 and 20 ± 3 μg · kg- 1, being50, 55 and 56 per cent of normal, respectively. We did not demonstrate a difference in sensitivity to vecuronium between those myasthenic patients who received pyridostigmine preoperatively and those who did not, nor among those chronically treated with corticosteroids, compared with those who were not.

AB - A cumulative dose plus infusion technique and integrated EMG monitoring of the first dorsal interosseous muscle were used to determine the potency of vecuronium in 20 normal patients and in ten patients with myasthenia gravis under thiamylal, N2O, O2, fentanyl anaesthesia. The mean (± SEM) values for ED50, ED90, and ED95 in the normal patients were 19 ± 1, 31 ± 1 and 36 ± 2 μg · kg- 1, respectively. Myasthenic patients showed increased sensitivity to vecuronium, the mean values for ED50, ED90, and ED95 were 10 ± 2, 17 ± 2 and 20 ± 3 μg · kg- 1, being50, 55 and 56 per cent of normal, respectively. We did not demonstrate a difference in sensitivity to vecuronium between those myasthenic patients who received pyridostigmine preoperatively and those who did not, nor among those chronically treated with corticosteroids, compared with those who were not.

KW - complications: myasthenia gravis

KW - measurement techniques: electromyography, neuromuscular blockade

KW - neuromuscular relaxants: vecuronium

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ER -

Sensitivity to vecuronium in myasthenia gravis: a dose-response study

Abstract

Keywords

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