Atracurium versus vecuronium: a comparison of recovery in outpatient arthroscopy

Atracurium 0.5 mg.kg-1 and vecuronium 0.1 mg.kg-1 were compared as neuromuscular relaxants for outpatient arthroscopy of the knee under general anaesthesia. In 40 unpremedicated patients divided at random into two groups, anaesthesia was induced with methohexitone, atracurium (Group A) or vecuronium (Group B), three per cent isoflurane prior to intubation and 0.9 per cent during maintenance with nitrous oxide 66 per cent in oxygen. Neuromuscular function was recorded by a Datex Relaxograph. Recovery was assessed by the time the patients took to open their eyes, to be able to answer five questions correctly, the time to recovery of ocular balance (Maddox Wing test) and by comparing pre- and postoperative performance of a paper and pencil test (the p-deletion test). Recovery tests showed no significant differences between groups. After three hours all the patients were fit for discharge. The patients were interviewed one month after the procedure. All were satisfied with their anaesthetic. "Full recovery" took 1.5 days with a range of 1 h-7 days. The only significant difference (p less than 0.01) between the groups was the need for pharmacological reversal of residual paralysis. In a procedure with a mean duration of 45.6 minutes, and using isoflurane, all but one patient (95 per cent) in the atracurium group required neostigmine versus nine patients in the vecuronium group (45 per cent).