Comparison between the Effects of Rocuronium, Vecuronium, and Cisatracurium Using Train-of-Four and Clinical Tests in Elderly Patients


Ozlem Sagir 1 , * , Funda Yucesoy Noyan 2 , Ahmet Koroglu 1 , Muslum Cicek 3 , Huseyin Ilksen Toprak 4

1 Department of Anesthesiology and Reanimation, Faculty of Medicine, Balikesir University, [email protected], Turkey

2 Department of Anesthesiology and Reanimation, Ye?ilyurt State hospital, Turkey

3 Department of Anesthesiology and Reanimation, Private Gazi Osmanpa?a Hospital, Turkey

4 Department of Anesthesiology and Reanimation, Faculty of Medicine, Inonu University, Turkey

How to Cite: Sagir O, Yucesoy Noyan F, Koroglu A, Cicek M, Ilksen Toprak H. Comparison between the Effects of Rocuronium, Vecuronium, and Cisatracurium Using Train-of-Four and Clinical Tests in Elderly Patients, Anesth Pain Med. Online ahead of Print ; 2(4):142-8. doi: 10.5812/aapm.8406.


Anesthesiology and Pain Medicine: 2 (4); 142-8
Published Online: March 26, 2013
Article Type: Research Article
Received: October 2, 2012
Accepted: November 20, 2012




Background: Postoperative residual blockade, longer duration of action for neuromuscular blockade, and slower recovery were relatively common in elderly patients.

Objectives: We aimed to investigate the safety of train-of-four ratio and clinical tests in the assessment of patient recovery, and to determine the effects of the rocuronium, vecuronium, and cisatracurium on intubation, extubation and recovery times in elderly patients undergoing abdominal surgery.

Patients and Methods: After obtaining institutional approval and informed consent, 60 patients over 60 years old and undergoing elective abdominal operations were included in this double-blind, randomized clinical trial. Following a standard anesthesia induction, 0.6mg kg-1 rocuronium, 0.1mg kg-1 vecuronium, and 0.1mg kg-1 cisatracurium were administered to the patients in Group R, Group V, and Group C, respectively. Train-of-four (TOF) ratios were recorded at 10-minute intervals during and after the operation. Modified Aldrete Score (MAS) and clinical tests were recorded in the recovery room at 10-minute intervals. In addition, intubation and extubation times, duration of recovery room stay, and any complications were recorded.

Results: Intubation time was found to be shorter in Group R than that in Groups V and C (P ? 0.001). Times to positive visual disturbances and grip strength tests were shorter in Group C than that in Group V (P = 0.016 and P = 0.011, respectively). In Group R and group C, time to TOF ? 0.9 was significantly longer than all positive clinical test times except grip strength (P < 0.05).

Conclusions: We hold the opinion that cisatracurium is safer in elderly patients compared to other drugs. We also concluded that the usage of TOF ratio together with clinical tests is suitable for assessment of neuromuscular recovery in these patients.


Neuromuscular Blockade Aged Rocuronium Cisatracurium Vecuronium Bromide

© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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