EFFECT OF NUTRITIONAL-STATUS ON VECURONIUM-INDUCED NEUROMUSCULAR BLOCKADE

Based an simple clinical and biochemical parameters of nutritional sta tus, seventy adult patients scheduled for elective surgery under gener al anaesthesia were categorized as having normal nutrition, mild, mode rate or severe malnutrition or obesity. Under anaesthesia, evoked resp onses on train-of-four nerve stimulation were recorded every 15 second s on a mechanomyograph. Vecuronium 0.1 mg.kg(-1) was used to achieve n euromuscular blockade. Compared with patients having normal nutrition, the time to onset of action was significantly prolonged in the modera te and severely malnourished groups; the time to no response on train- of-four simulation was delayed only in severely malnourished groups (P <0.001). The duration of action of the initial dose was shorter in the moderate and severely malnourished groups. The obese group had an ear lier onset of action and a longer duration of action compared with pat ients of normal nutrition (P<0.001). No significant difference in reco very time to a trin-of-four of 0.70 was observed between the malnouris hed and patients with normal nutrition. Malnutrition has a marked effe ct on vecuronium-induced neuromuscular blockade.