Distribution, elimination, and action of vecuronium in the elderly. Anesth Analg 1991 Jul;73(1):39-42
Date
07/01/1991Pubmed ID
1677546DOI
10.1213/00000539-199107000-00008Scopus ID
2-s2.0-0025733182 (requires institutional sign-in at Scopus site) 56 CitationsAbstract
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.
Author List
Lien CA, Matteo RS, Ornstein E, Schwartz AE, Diaz JAuthor
Cynthia A. Lien MD Chair, Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Aging
Anesthesia
Fentanyl
Humans
Middle Aged
Nitrous Oxide
Surgical Procedures, Operative
Vecuronium Bromide
