European journal of anaesthesiology. Supplement
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Eur J Anaesthesiol Suppl · Sep 1995
ReviewOnset time and evaluation of intubating conditions: rocuronium in perspective.
The customary methods for assessment of intubating conditions, namely the onset time in the adductor pollicis muscle and qualitative rating scales of the conditions at intubation, are unsatisfactory. The onset time of neuromuscular block in the adductor pollicis is not a meaningful, quantifiable endpoint, defining optimal intubating conditions. ⋯ Clinical studies simulating rapid sequence induction in elective patients indicate that rocuronium 0.9 mg kg-1 may be suitable for crash intubation. This, however, needs to be confirmed in emergency cases.
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Clinical TrialDose-response, time-course of action and recovery of rocuronium bromide in children during halothane anaesthesia.
Two groups of children, aged 1-4 years (n = 28) and 5-10 years (n = 28), respectively, received at random one of four doses of rocuronium (0.12, 0.17, 0.22 or 0.27 mg kg-1). When maximum block was obtained, further rocuronium to a total dose of 0.5 mg kg-1 was given. At a spontaneous T1 recovery of 25% the block was reversed with atropine and neostigmine in half the patients. ⋯ Neostigmine administration reduced recovery time by approximately half to two-thirds. MAP was not influenced by rocuronium. Following the injection of rocuronium in the younger age group there was a 15% increase in heart rate compared to a 10% increase in the age group 5-10 years.
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialPriming studies with rocuronium and vecuronium.
We studied the effects of rocuronium and vecuronium as priming agents before both vecuronium and rocuronium neuromuscular blockade. Rocuronium is ineffective at priming rocuronium. Vecuronium is effective at priming rocuronium, producing an approximate 33% reduction in onset time. Rocuronium and vecuronium, when given as priming agents, both reduce the onset time of vecuronium block.
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Eur J Anaesthesiol Suppl · Sep 1995
Comparative Study Clinical TrialCross-reactivity of rocuronium with other neuromuscular blocking agents.
The cross-reactivity of rocuronium with other neuromuscular blocking agents (NMBAs) was studied in 31 patients known to be allergic to a muscle relaxant. Tests for diagnosing cross-reactivity were skin tests (prick tests and intradermal tests: IDTs), detection by RAST assay of IgEs against the quaternary ammonium group (QAS-RIA: quaternary ammonium sepharose radio-immuno-assay), QAS-RIA inhibition test to detect IgE specificity, and leucocyte histamine release test (LHRT). Skin tests were performed with rocuronium, suxamethonium, gallamine, vecuronium, pancuronium, atracurium. ⋯ In one of the five patients allergic to all the NMBAs available, rocuronium was the only one which did not cross-react. In those 10 patients, rocuronium may be safely used for subsequent anaesthesia. In terms of allergy, rocuronium appeared to be very close to the other steroidal NMBAs.
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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.