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Lower oesophageal reflux during priming with vecuronium
C Martin1, J C Guillen, B Dupin
1Département d'Anesthésie-Réanimation, Hôpital Sainte Marguerite, Marseille, France.
British Journal of Anaesthesia
|January 1, 1990
Summary
Vecuronium, when administered as a priming dose before intubation, does not increase the risk of esophageal acid reflux. This study found no significant difference in reflux events between patients receiving a priming dose and those who did not.
Area of Science:
- Anesthesiology
- Gastroenterology
- Pharmacology
Background:
- Acid reflux during anesthesia induction is a concern.
- Vecuronium is a neuromuscular blocking agent used in anesthesia.
- The 'priming principle' involves administering a small dose before the main dose.
Purpose of the Study:
- To investigate the effect of a vecuronium priming dose on esophageal acid reflux.
- To determine if the priming principle with vecuronium increases the risk of gastroesophageal reflux.
Main Methods:
- Two groups of 16 patients were studied.
- Patients received thiopentone and fentanyl for induction.
- One group received a vecuronium priming dose (0.01 mg kg-1) followed by an intubation dose (0.1 mg kg-1) 4 minutes later; the control group received only the intubation dose.
- Lower esophageal pH was continuously monitored to detect acid reflux (pH < 4.0).
Main Results:
- One patient in each group experienced acid reflux during induction.
- No significant difference in the frequency of acid reflux was observed between the vecuronium priming group and the control group.
Conclusions:
- Administering vecuronium 0.01 mg kg-1 as a priming dose does not appear to elevate the risk of esophageal acid reflux.
- The priming principle with vecuronium can be safely employed without increasing the likelihood of acid reflux events.