European journal of anaesthesiology. Supplement
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Many factors influence the minimum time required to achieve an easy and successful tracheal intubation after a non-depolarizing relaxant. The ideal study design has never been achieved in practice: an overall picture of the efficacy of rocuronium depends on careful interpretation of studies with different methodologies, which have usually compared the new drug with vecuronium or suxamethonium, currently the best alternatives. ⋯ Although some studies have produced evidence that rocuronium can produce smooth easy intubation conditions in 60 s, 90 s would appear to be closer to the time when excellent conditions can be guaranteed. Whether this is an acceptable alternative to the 45 s or so needed after suxamethonium is a matter of clinical judgement which only testing in practice will answer.
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Eur J Anaesthesiol Suppl · Jan 1994
The contribution of muscle relaxants to the advancement of anaesthetic practice: what is required of new compounds?
The introduction of each new muscle relaxant has advanced anaesthetic practice by trying to meet some perceived deficiency in the existing therapeutic armamentarium. Anaesthesiologists need agents which are appropriate to the duration of surgery: they prefer agents which are not subject to drug interaction, have no effect on cardiovascular function, which do not depend significantly on renal excretion, which are easy to reverse, and which have a rapid onset of action. In certain circumstances one of these requirements becomes overridingly important. The latest new addition, rocuronium, fills the gap for an agent with rapid onset while lacking the potentially adverse features of suxamethonium, retaining a medium duration of action and meeting the other requirements set out above as well as any existing agent.
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Eur J Anaesthesiol Suppl · Jan 1994
An overview of the pharmacology of rocuronium bromide in experimental animals.
In various animal species anaesthetized with a-chloralose (cats and pigs) or pentobarbitone (Beagle dogs and Rhesus monkeys), rocuronium has been shown to be a readily reversible, non-depolarizing neuromuscular blocking agent with a similar duration of action as vecuronium but a 6-10 fold lower potency. The outstanding features of its action is rapidity of onset. ⋯ There is no evidence of any selective pre-junctional effect and there is no clinically relevant inhibition of acetycholinesterase. Screening in rats has not demonstrated any oestrogenic, androgenic, anabolic, glucocorticoid-like or gonad-inhibiting properties, although there was a slight increase in pituitary weight in male rats.