[The effect of corticosteroids on the recovery from vecuronium induced block]

The effects of corticosteroids (hydrocortisone, methylprednisolone) on the recovery time from the vecuronium induced neuromuscular block were studied using evoked potential measurements by stimulating ulnar nerve. Plasma concentrations of vecuronium were examined after the administration of hydrocortisone and methylprednisolone using high performance liquid chromatography in 78 surgical patients. Recovery time from the block induced by vecuronium was prolonged by corticosteroids. In case of hydrocortisone, this prolongation effect was significant (P less than 0.01). In the study of plasma concentration, blood samples were taken 40 minutes after administration of vecuronium, plasma concentration of vecuronium is significantly higher in patients given hydrocortisone (124 +/- 8.32 ng.ml-1) (mean +/- SE) than control patients (68.2 +/- 4.71 ng.ml-1) (P less than 0.001). It is speculated that corticosteroids lower the clearance of vecuronium. Prolongation of recovery time from vecuronium induced block after the administration of corticosteroids may be explained not only by the direct effect of hydrocortisone on the neuromuscular junction but also by the effect of hydrocortisone to prolong the elimination of vecuronium from plasma.