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Seven of the 16 patients had prolonged neuromuscular blockade,lasting from six hours to more than seven days,after the termination of vecuronium therapy.These seven patients,six of whom were women,had higher plasma magnesium concentrations and lower arterial blood pH values than the nine patients without prolonged neuromuscular blockade.They also had higher plasma concentrations of 3-desacetylvecuronium and a higher frequency of renal failure(seven of seven patients vs.four of nine patients,P<0.03).In the patient without prolonged neuromuscular blockade,the mean(=/-SD)plasma clearance,elimination half-life,and volume of distribution of vecuronium were 2.5+/-1.0 ml per kilogram of body weight per minute,299+/-154 minutes,and 1.1+/-0.6 liters per kilogram,respectively.Conclusions. Prolonged neuromuscular blockade after the termination of long-term treatment with vecuronium is associated with metabolic acidosis,elevated plasma magnesium concentrations,female sex,and probably more important,the presence of renal failure and high plasma concentrations of 3- desacetylvecuronium. |
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