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
Clinical Trial Controlled Clinical TrialRocuronium bromide in the ICU: dose finding and pharmacokinetics.
Thirty patients requiring elective ventilation in the ICU received either intermittent boluses (25 patients) or a continuous infusion (five patients) of rocuronium. Degree of block was monitored by train-of-four stimuli and maintained at one twitch either observed or palpated. ⋯ Control of ventilation was better with the continuous infusion of rocuronium, but these patients also had a more intense block receiving 9.9 +/- 1.3 micrograms kg-1 min-1 as compared to 6.4 +/- 2.3 micrograms kg-1 min-1 in the bolus group. Elimination half-time, volume of distribution at steady-state, and mean residence time were significantly greater than in surgical patients receiving comparable infusions, but plasma clearance was similar.
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Eur J Anaesthesiol Suppl · Sep 1995
Clinical TrialThe effect of dose and the rate of stimulation on the action of rocuronium.
We studied the effect of administering multiples of the ED90 dose of rocuronium on the onset, duration and recovery index of neuromuscular block. The effect on onset time differed from that reported using train-of-four stimulation. This led us to investigate the effect of increasing the rate of ulnar nerve stimulation 10-fold. This resulted in an approximately 50% reduction in the time to complete block.