Resistance to vecuronium.

Norman, J · Anaesthesia · 1993

case_report · Level V

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Abstract

A 19-year-old epileptic patient taking carbamazepine was anaesthetised for a sigmoid colectomy. Such patients are reported to show a resistance to the actions of competitive neuromuscular blocking drugs, and a conventional dose of vecuronium (0.1 mg.kg-1) produced relaxation for only 18 min. Subsequently she received vecuronium 6.7 mg.h-1 which kept the first twitch of the train-of-four response at 30% of the control value. Antagonism with neostigmine 1.25 mg produced a rapid and full recovery. The report illustrates the usefulness of monitoring neuromuscular transmission whenever there is an anticipation of an altered response.

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