COMPARISON OF CONTINUOUS INFUSION OF VECURONIUM AND ATRACURIUM IN LAPAROTOMIES AT SMCH, GHAZIABAD, U.P.

Abstract

Sixty adult patients of either sex, 25 – 45 years of age, belonging to ASA physical status I or II, who were scheduled for midline and paramedian
laparotomies under general anaesthesia lasting for up to two hours were recruited for a prospective randomized controlled study intended to
compare vecuronium and atracurium when the drugs were used as a continuous infusion. The drugs were compared with respect to recovery from
neuromuscular blockade on stopping the infusion and cardiovascular performance. The study was approved by the Institutional Ethics Committee
and all patients enrolled provided written informed consent. Patients were randomly allocated into two equal groups and received either
vecuronium (Group I) or atracurium (Group II) in intravenous infusion for maintenance of muscle relaxation. Fentanyl was used as analgesic and
inductions were done with thiopental and intubation with vecuronium (0.1 mg/kg body weight) in Group I patients and atracurium (0.5 mg/kg body
weight) in Group II patients. Anesthesia was maintained with 33% oxygen in nitrous oxide and incremental doses of fentanyl and propofol infusion
at a rate of 2-4 mg /kg/hour. Intravenous infusions of muscle relaxants were adjusted to maintain 90% of neuromuscular blockade monitored by
stimulating ulnar nerve at the wrist by a peripheral nerve stimulator throughout surgery. At the end of the procedure, at 25% recovery of twitch
height, neuromuscular blockade was reversed with neostigmine and glycopyrrolate.