Safety of muscle relaxant antagonism for patients with heart disease and non-heart operation during post-anesthesia recovery period

Abstract:

Objective：To study the efficacy and safety of using neostigmine antagonism vecuronium bromide for patients with heart disease undergoing non-heart operation under general anesthesia in post-anesthesia recovery room（PACU）. Methods：Totally 180 pa－tients of American Society of Anesthesiologists（ASA）Ⅱ-Ⅲ level，19-65 year-old，complicated with hypertensive cardiopathy，coronary heart disease，rheumatic heart disease and pulmonary heart disease，undergoing non-heart operation under general anesthesia were randomly selected. After entering PACU，patients were randomly divided into 3 groups：control group（C group），using no muscle loose antagonistic drugs during anesthesia recovery period until recovery，neostigmine single medication group（N group） intravenous injec－tion of neostigmine 40 μg and atropine 20 μg when train of four（TOF） reaching 25%，neostigmine twice to medicine group（M group），intravenous injection of neostigmine 20 μg/kg and atropine 10 μg/kg when TOF reaching 25% and 75% respectively. Vital signs were monitored in three groups. Extubation time from TOF 25% to 90% and PACU discharging time when Aldrete score reaching 9 were recoded. Hypotension，hypertension，cardiac arrhythmia，arterial blood gas analysis，reintubation rate，incidence of nausea and vomiting and delirium were recorded in three groups during the periods mentioned above. Results：Extubation time was significantly shortened in N and M groups than in group C（P<0.01） without significant differences in complication rate between groups. Conclusions：Rea－sonable application of muscle relaxant antagonism for patients with heart disease undergoing non-heart operation in PACU can pro－mote muscle contraction function recovery，shorter extubation time under general anesthesia without inducing adverse events，therefore is safe and feasible.