Anthropometric Variables as Predictors for Duration of Action of Vecuronium-Induced Neuromuscular Block

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To identify the best anthropometric predictor for duration of action of neuromuscular block and to propose a better dosing regimen for vecuronium in obese patients, we studied 67 female patients (body weight 45–126 kg) anesthetized with thiopental, fentanyl, droperidol, and nitrous oxide. Twelve different anthropometric variables were evaluated as predictors for duration of action. Simple and multiple linear, least-squares, regression analyses were used. The predictors with the greatest correlation coefficients for duration of action of the vecuronium induction dose (100μg/kg) were percentage of ideal body weight (%IBW) (r2 = 0.389, P = 0.0001) and body mass index (r2 = 0.379, P = 0.0001). Body weight alone was also correlated to duration of action, but the r2 value was less (r2 = 0.312, P = 0.0001). The most significant predictors of the first supplementary dose of vecuronium (33μg/kg) were the sum of subscapularis and suprailiac skin folds divided by surface area (r2 = 0.264, P = 0.0001) and %IBW (r2 = 0.261, P = 0.0001). We conclude that %IBW, the body mass index, and the sum of subscapularis and suprailiac skin folds divided by the surface area are the best predictors of duration of action of a vecuronium neuromuscular block.

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