European journal of anaesthesiology. Supplement
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Eur J Anaesthesiol Suppl · Sep 1995
Clinical Trial Controlled Clinical TrialThe influence of hypothermia (surface cooling) on the time-course of action and on the pharmacokinetics of rocuronium in humans.
Hypothermia prolongs the time-course of action of non-depolarizing neuromuscular blocking agents. The mechanism, however, is unknown. We studied the influence of hypothermia (by surface cooling, nasopharyngeal temperature < or = 31 degrees C) on the time-course of action and on the pharmacokinetics of rocuronium in humans. ⋯ Hypothermia (30.4 +/- 0.8 degrees C (mean +/- SD)) increased the duration of action, temperature dependently, and delayed the recovery. Hypothermia reduced the plasma clearance significantly (2.17 +/- 0.62 vs. 4.26 +/- 0.50 mL kg-1 min-1, P = 0.004), did not change the volume of distribution (224 +/- 64 vs. 232 +/- 60 mL kg-1 min-1, P = 1.0), and prolonged the mean residence time (108 +/- 39 vs. 56 +/- 19 mL kg-1 min-1, P = 0.01). We conclude that hypothermia prolongs the duration of action of rocuronium and delays spontaneous recovery and that altered pharmacokinetics, such as a decreased clearance, play an important role in this.
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Eur J Anaesthesiol Suppl · Sep 1995
Comparative Study Clinical TrialDose-response and time-course of effect of rocuronium bromide in paediatric patients.
We determined dose-response curves and spontaneous recovery of neuromuscular function following a single ED95 dose of rocuronium in 10 infants (1-11 months old), 20 children (2-12 years old) and 20 adults (20-40 years old) during nitrous oxide-oxygen-thiopentone-alfentanil anaesthesia. Neuromuscular block was recorded as adductor pollicis EMG following a supramaximal train-of-four ulnar nerve stimuli at 10 s intervals. ⋯ Time-course of recovery from an average 94% neuromuscular block was similar in all age groups with a 25-75% recovery time of 6.5 +/- 1.8, 5.7 +/- 1.8 and 6.7 +/- 1.6 min in infants, children and adults, respectively. Thus, rocuronium is an intermediate-acting muscle relaxant in all age groups.
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Eur J Anaesthesiol Suppl · Sep 1995
Clinical Trial Controlled Clinical TrialRocuronium with alfentanil and propofol allows intubation within 45 seconds.
Following induction with alfentanil (20 micrograms kg-1) and propofol (2.0-2.5 mg kg-1), four groups of patients were given rocuronium to determine conditions for rapid sequence intubation. Two groups received 0.9 mg kg-1 and two groups received 0.6 mg kg-1. ⋯ Intubating conditions were scored on a four point scale but all were rated as excellent or good. Almost all intubating conditions were excellent in the 0.9 mg kg-1 groups.