Gabexate mesilate hastens recovery from vecuronium-induced neuromuscular blockade.

Background and objective: To test the hypothesis that gabexate mesilate, a protease inihibitor, hastens recovery from neuromuscular blockade, we examined the effect of gabexate mesilate on the recovery of vecuronium-induced neuromuscular blockade in anaesthetized patients in a double-blind, randomized fashion. Methods: Thirty adult patients were divided into two groups of 15. In the gabexate mesilate group, immediately after administration of vecuronium 0.1 mg kg - 1 , a continuous infusion of gabexate mesilate was started at a speed of 1.5 mg kg - 1 h - 1 . In the control group, normal saline was administered instead of gabexate mesilate. Times to the return of T 1 , T 2 , T 3 or T 4 (first, second, third and fourth response of train-of-four (TOF)), times to the recovery of Τ 1 /control to 0.25 (T25) or 0.5 (T50), recovery of T 1 /control or TOF ratio (T 4 /T 1 ) were compared between the two groups. Results: Times to the returns of T 1 , T 2 , T 3 and T 4 in the gabexate mesilate group were significantly shorter than in the control group (19.4 ′ 6.8 vs. 25.7 ′ 7.2 min for T 1 ; mean ′ SD, P = 0.020). Times to T25 and T50 were significantly shorter in the gabexate mesilate group than in the control group (34.0 ′ 9.9 vs. 51.5 ′ 10.2 min for T25, P < 0.001). T 1 /control and TOF ratio in the gabexate mesilate group were significantly higher than in the control group 40-80 min and 40-120 min after administration of vecuronium, respectively (P < 0.05). Conclusion: Gabexate mesilate hastens recovery from neuromuscular block in anaesthetized patients receiving vecuronium.