Influência do propofol e do etomidato no bloqueio neuromuscular produzido pelo rocurônio: avaliação pela aceleromiografia

Influência do propofol e do etomidato no bloqueio neuromuscular produzido pelo rocurônio: avaliação pela aceleromiografia

Brazilian Journal of Anesthesiology, November 2002

19475238

Derli Conceição Munhoz, Angélica de Fátima de Assunção Braga, Glória Maria Braga Potério

Some hypnotics may interact with neuromuscular blockers and potentiate their effects. This study aimed at evaluating the influence of propofol and etomidate on rocuronium-induced neuromuscular block. Participated in this study 60 patients, physical status ASA I and II, scheduled for elective surgeries under general anesthesia, who were randomly distributed in two groups according to the hypnotic drug: Group I (propofol) and Group II (etomidate). All patients were premedicated with intramuscular midazolam (0.1 mg.kg-1), 30 minutes before surgery. Anesthesia was induced with propofol (2.5 mg.kg-1) or etomidate (0.3 mg.kg-1) preceded by alfentanil (50 microg.kg-1) and followed by rocuronium (0.6 mg.kg-1). Patients were ventilated under mask with 100% oxygen until achieving a decrease of 75% or more in the adductor pollicis muscle response amplitude. Neuromuscular function was monitored by accelerometry. The following parameters were evaluated: rocuronium onset (T1 <= 25%); time for complete neuromuscular block; neuromuscular block degree at tracheal intubation; tracheal intubation conditions and hemodynamic effects. Complete rocuronium-induced neuromuscular block onset times (in seconds) were: Group I (48.20 +/- 10.85 s and 58.87 +/- 10.73 s) and Group II (51.20 +/- 13.80 s and 64.27 +/- 18.55 s). Neuromuscular block degree at tracheal intubation was: Group I (77.50%) and Group II (76.96%). Tracheal intubation conditions were satisfactory in 100% of Group I patients and in 83.33% of Group II patients. There has been a significant decrease in mean blood pressure, followed by an increase after hypnotic injection, in both groups. Propofol and etomidate had a similar behavior regarding time for rocuronium-induced neuromuscular block and tracheal intubation conditions.