• M Beaussier, A Boughaba, E Schiffer, B Debaene, A Lienhart, and A d'Hollander.
• St-Antoine Hospital, Department of Anaesthesia and Intensive Care, Paris, France. marc.beaussier@sat.ap-hop-paris.fr
• Eur J Anaesthesiol. 2006 Sep 1;23(9):755-9.

Background And ObjectiveThe aim of this prospective study was to compare the effect of the administration of desflurane or sevoflurane to a fixed neuromuscular block.MethodsAfter written consent, 12 patients were anaesthetized with propofol and sufentanil. Atracurium was administered via a continuous infusion in order to obtain 85% twitch depression of the control value assessed by repeated accelerometric stimulation at the adductor pollicis. Once stabilized over the course of 30 min, propofol was discontinued and either desflurane (n = 6) or sevoflurane (n = 6) was delivered at 1 MAC in a mixture of 50% O(2) in air. Study parameters were the magnitude and the time of twitch height variations. Results are presented in mean +/- SD.ResultExposure to halogenated agents led to a significant reduction in twitch height with similar magnitude between the two agents. However, interaction with desflurane showed an initial and transient rise (35 +/- 22%) in twitch height before subsequent depression occurred. The time to reach 50% of the signal depression in the desflurane group was significantly delayed (25 +/- 7 vs. 11 +/- 4 min in the sevoflurane group; P < 0.01).ConclusionsOn a stable neuromuscular block elicited by continuous infusion of atracurium, the abrupt administration of desflurane or sevoflurane reduces the accelerometric responses of the adductor pollicis in a similar way. This potentiating effect is produced faster after sevoflurane than after desflurane. With desflurane, a biphasic effect (of a transient and moderate increase followed by depression of the signal) was recorded.

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