Clinical variability of vecuronium. Experience at an institution in Colombia

Abstract Objective To establish the variability of vecuronium (lag-time, latency duration, clinical duration and complete recovery), original molecule, in a group of patients who received the agent prior to surgery under general anesthesia with endotracheal intubation. Materials and methods Observational, prospective study including 20 adult patients – ASA I or II classification – selected on the basis of suitability, who received general anesthesia and vecuronium as neuromuscular relaxant. Remifentanyl and propofol were the induction agents. The neuromuscular activity was quantified using a TOF-WATCH SX ® stimulator, establishing lag-time, duration of latency, clinical duration and complete recovery. The data were analyzed using STATA 10. Results The data on lag-time to complete recovery are given as medians: lag-time: 32.5 seconds; latency time: 240 seconds; clinical length 25: 43.5 min; clinical length 50: 57.5 min; clinical length 75: 58.5 min; clinical length 100: 55 min; complete recovery: 87 min; need for reversion: 55%; adverse effects: none. Conclusions The results obtained suggest a broad variability between the time of administration of vecuronium, its clinical effect and duration of action, all of which were above the levels recorded in the literature. This suggests that the agent is long-acting and highly unpredictable. We recommend neuromuscular function monitoring as an indispensable routine and preferably quantitative.