Recovery from vecuromium is delayed in patients with hypercholesterolemia

Abstract

Purpose: To examine the effects of hypercholesterolemia with respect to onset time and recovery from vecuronium-induced neuromuscular block. Methods: A randomized controlled trial was undertaken in 20 adult patients with hypercholesterolemia (hypercholesterolemia group) and 20 healthy patients with normal serum cholesterolemia (control group). Following induction of anesthesia, vecuronium 0.1 mg·kg-1 iv was administered. Onset of neuromuscular block and recovery times in the two groups were compared using supramaximal stimulation of the ulnar nerve. Results: The supramaximal stimulating current in the hypercholesterolem ia group was similar to that of the control group (38.1 ± 15.5 vs 31.3 ± 7.6 mA, P = 0.087). Onset of vecuronium-induced neuromuscular block (time to loss of response to T1) in the hypercholesterolemia group was similar to that observed in the control group (243 ± 84 vs 249 ± 56 sec, P = 0.792). Times from vecuronium administration to the return of T1 were also similar in the two groups (29.8 ± 9.7 vs 25.3 ± 6.8 min, P = 0.099). However, mean times for return of T2, T3, and T4 in the hypercholesterolemia group were longer than in the control group (44.5 ± 14.4 vs 34.0 ± 8.4 min for T2, P = 0.018). During recovery from neuromuscular block, T1/control and train-of-four ratio in the hypercholesterolemia group were less than in the control group, 90-120 min and 70-120 min after vecuronium, respectively (P < 0.05). Conclusion: Recovery from vecuronium-induced neuromuscular block is delayed in patients with hypercholesterolemia.