European journal of anaesthesiology. Supplement
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Clinical TrialEvaluation of neuromuscular effects and antagonism of rocuronium bromide: a preliminary report.
Twenty ASA I-II patients received either 2 or 3 x ED95 doses of rocuronium bromide during nitrous oxide, oxygen, propofol, fentanyl-based anaesthesia. The mean times to maximum block were 98 s and 74 s and the mean duration of clinical relaxation (recovery to 25% T1) was 35 min and 46 min following 620 micrograms kg-1 and 930 micrograms kg-1, respectively. Neuromuscular blockade was antagonized with either neostigmine or edrophonium from a twitch height of 25%. Although there was no significant difference between the recovery times neostigmine appeared to give more consistent antagonism of rocuronium-induced blockade.
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialTime-course of action and intubating conditions with rocuronium bromide under propofol-alfentanil anaesthesia.
Thirty ASA I and II patients received either an intubating dose of 0.6 mg kg-1 rocuronium (2 x ED95, group 1) or 0.06 mg kg-1 as a priming dose followed by an intubating dose of 0.24 mg kg-1 rocuronium (group 2) 4 min later. Anaesthesia was induced with propofol (2.0 mg kg-1) and alfentanil (0.02 mg kg-1) and maintained with nitrous oxide/oxygen and propofol (6.0 mg kg-1 h-1). Neuromuscular function was monitored mechanomyographically and electromyographically with train-of-four (TOF) stimulation at the wrist every 10 s. ⋯ Mechanomyography showed a significantly faster development of neuromuscular block than electromyography. The comparison of mechanomyographically and electromyographically measured recovery times did not show any differences. In 60% of the patients a priming dose of 0.06 mg kg-1 was followed by a considerable decrease in neuromuscular function.
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Eur J Anaesthesiol Suppl · Sep 1995
Comparative Study Clinical Trial Controlled Clinical TrialIntubation conditions and time-course of action of low-dose rocuronium bromide in day-case dental surgery.
A relatively small dose of rocuronium (0.45 mg kg-1) was compared with equipotent doses of atracurium (0.35 mg kg-1) and vecuronium (0.075 mg kg-1) for ease of intubation at 60 s. All patients could be intubated but the proportion with excellent or good conditions was much greater with rocuronium. Mean clinical duration of effect of this dose was 22.2 min. There was no correlation between intubating conditions and the degree of block of the adductor policis.
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialRocuronium- and mivacurium-induced neuromuscular block and intubating conditions: a comparison with vecuronium.
The time-course of action after an initial 2 x ED90 dose and after maintenance doses of 0.5 x ED90, and intubating conditions at 90 s after a 2 x ED90 dose following rocuronium, vecuronium and mivacurium were evaluated in anaesthetized adult patients. Neuromuscular measurements were performed with mechanomyography. ⋯ At 90 s, intubating conditions were significantly better in the rocuronium group than in the vecuronium or mivacurium group. Mivacurium offered a significantly faster recovery of neuromuscular block following the 2 x ED90 dose and following an average of 45 min of clinical muscle relaxation (single twitch response < or = 25%) compared to rocuronium and vecuronium: clinical duration 13 (4), 28 (9) and 33 (9) min, respectively, and recovery time from 25 to 75% recovery of the single twitch response: 6 (2), 11 (4) and 14 (7) min, respectively.
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Eur J Anaesthesiol Suppl · Sep 1995
ReviewThe pharmacokinetics of rocuronium bromide in hepatic cirrhosis.
The pharmacokinetics of aminosteroid neuromuscular blocking drugs have been shown to be altered in patients with hepatic cirrhosis. A reduced clearance and prolonged elimination half-life of pancuronium and vecuronium have been demonstrated. ⋯ Nevertheless, rocuronium, even in cirrhotic patients, has the fastest onset of action of any non-depolarizing neuromuscular blocking agent. Further pharmacokinetic studies are necessary of this drug in hepatic cirrhosis.