Diabetic autonomic neuropathy and the haemodynamic actions of vecuronium and pancuronium during vitrectomy

In order to clarify whether autonomic neuropathy modifies the haemodynamic effects of alfentanil, vecuronium and pancuronium, twenty-seven patients with diabetes mellitus were studied at thiopentone induction, and during nitrous oxide anaesthesia for ophthalmic vitreous surgery. Heart rate was lower in the diabetic patients receiving vecuronium compared with those receiving pancuronium, but no difference was seen in arterial pressure. During and after anaesthesia induction, the profiles of heart rate and arterial pressure resembled those found in healthy controls. Even in patients with advanced autonomic neuropathy, anaesthetics may exert their inherent vagotonic or sympathicotonic actions.