Prediction of infusion rates: validation of a computer simulation using vecuronium.

Abstract

In Phase 1 of the study a loading dose of vecuronium was given to 24 patients, followed by a sequence of infusions and boluses. The relationship between the duration of a bolus dose and the infusion rate necessary to maintain the required degree of neuromuscular block was demonstrated. In Phase 2 the data acquired from Phase 1 were used in an attempt to produce a predetermined degree of neuromuscular block. The aim was a block of neuromuscular function so that the height of the first twitch of a train-of-four was 15% of control. In the 10 patients studied the average height was 14.7% (SD 4.95%). It was concluded that it is possible to predict accurately the infusion dose of vecuronium required to achieve a predetermined degree of neuromuscular block, according to the duration of action of one or two test doses.