Alfentanil combined with vecuronium or pancuronium for use in eye surgery

The usefulness of alfentanil for eye surgery, when combined with either vecuronium or pancuronium, was evaluated in 44 fit anticholinergized patients. Following thiopentone, four min after the administration of the relaxant (0.1 mg/kg), and two min after the administration of alfentanil (15 micrograms/kg), a sixth of the patients bucked on introducing the endotracheal tube. The anesthesia for cataract extraction was maintained using alfentanil-relaxant-N2O in 18 patients. In 16 of them, a low dose alfentanil regimen, occasionally supplemented with thiopentone, was satisfactory, and the recovery of alertness was rapid. In 26 patients, alfentanil, 25 micrograms/kg, supplemented with isoflurane, efficiently obtunded the hemodynamic response after traction of extrinsic eye muscles at the commencement of major surgery. The patients receiving vecuronium presented with lower heart rates, than did those receiving pancuronium (P < 0.05). During major operations, nodal rhythm was more frequent in the vecuronium group, than in the pancuronium group (P < 0.0001).