Biomaterial Database

[Comparison of vecuronium doses in general anesthesia administered with remifentanil or fentanyl]. 2012

Kiyoshi Nagase, and Hiroki Iida

Operation Division, Gifu University Hospital, Gifu 501-1194.

BACKGROUND It is recommended to minimize neuromuscular blocker administration during general anesthesia for the efficacy of operating room utilization and potential hazards of unintended awareness during anesthesia. METHODS We retrospectively compared the dose of vecuronium in consecutive 8,007 patients under general anesthesia receiving remifentanil or fentanyl. In analyzing electronic anesthesia records over 4 years in a single university institute, we also examined the type of general anesthesia and the required time of each pro- cedure in the operating room. RESULTS Less vecuronium was necessary in patients administered remifentanil than those given fentanyl both maintained with inhalational and intravenous anesthesia. Supplementation with epidural anesthesia did not influence the dose of vecuronium in patients under general anesthesia receiving remifentanil or fentanyl. We also measured the time necessary before extubating trachea after finishing surgery, while no difference was found between the patients recieving remifentanil and fentanyl. CONCLUSIONS Anesthesia with remifentanil reduces requirement of vecuronium dose greater than with fentanyl, while it does not affect the emergence time from anesthesia.

UI	MeSH Term	Description	Entries
D010880	Piperidines	A family of hexahydropyridines.
D003473	Neuromuscular Nondepolarizing Agents	Drugs that interrupt transmission at the skeletal neuromuscular junction without causing depolarization of the motor end plate. They prevent acetylcholine from triggering muscle contraction and are used as muscle relaxants during electroshock treatments, in convulsive states, and as anesthesia adjuvants.	Curare-Like Agents,Curariform Drugs,Muscle Relaxants, Non-Depolarizing,Neuromuscular Blocking Agents, Competitive,Nondepolarizing Blockers,Agents, Curare-Like,Agents, Neuromuscular Nondepolarizing,Blockers, Nondepolarizing,Curare Like Agents,Drugs, Curariform,Muscle Relaxants, Non Depolarizing,Non-Depolarizing Muscle Relaxants,Nondepolarizing Agents, Neuromuscular
D005283	Fentanyl	A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)	Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077208	Remifentanil	A piperidine-propionate derivative and opioid analgesic structurally related to FENTANYL. It functions as a short-acting MU OPIOID RECEPTOR agonist, and is used as an analgesic during induction or maintenance of general anesthesia, following surgery, during childbirth, and in mechanically ventilated patients under intensive care.	3-(4-Methoxycarbonyl-4-((1-oxopropyl)phenylamino)-1-piperidine)propanoic Acid Methyl Ester,GI 87084B,GI-87084B,GI87084B,Remifentanil Hydrochloride,Remifentanil Monohydrochloride,Ultiva
D000768	Anesthesia, General	Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.	Anesthesias, General,General Anesthesia,General Anesthesias
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective
D014673	Vecuronium Bromide	Monoquaternary homolog of PANCURONIUM. A non-depolarizing neuromuscular blocking agent with shorter duration of action than pancuronium. Its lack of significant cardiovascular effects and lack of dependence on good kidney function for elimination as well as its short duration of action and easy reversibility provide advantages over, or alternatives to, other established neuromuscular blocking agents.	NC-45,Norcuron,ORG-NC 45,ORG-NC-45,ORG-NC45,Vecuronium,Vecuronium Bromide, Quaternary Ion,Vecuronium Citrate,Vecuronium Hydrobromide,Vecuronium Hydrochloride,Vecuronium Maleate,Vecuronium Phosphate,Bromide, Vecuronium,Citrate, Vecuronium,Hydrobromide, Vecuronium,Hydrochloride, Vecuronium,Maleate, Vecuronium,NC 45,NC45,ORG NC 45,ORG NC45,ORGNC 45,ORGNC45,Phosphate, Vecuronium
D018686	Anesthetics, Intravenous	Ultrashort-acting anesthetics that are used for induction. Loss of consciousness is rapid and induction is pleasant, but there is no muscle relaxation and reflexes frequently are not reduced adequately. Repeated administration results in accumulation and prolongs the recovery time. Since these agents have little if any analgesic activity, they are seldom used alone except in brief minor procedures. (From AMA Drug Evaluations Annual, 1994, p174)	Intravenous Anesthetic,Intravenous Anesthetics,Anesthetic, Intravenous