European journal of anaesthesiology. Supplement
-
Eur J Anaesthesiol Suppl · Jan 1994
ReviewInteractions of volatile anaesthetics with rocuronium bromide in perspective.
A review of several publications shows that there is general agreement that inhalational anaesthetic agents potentiate the neuromuscular effects of rocuronium in the same order as other similar agents, namely; enflurane and isoflurane > halothane > intravenous anaesthetics. However, such potentiation is not evident during induction and only becomes significant as anaesthesia becomes more prolonged. It is manifest as a prolongation in the duration of action of maintenance doses and a decrease in the recovery rate. During long-lasting procedures in which enflurane or isoflurane are used, smaller than usual maintenance doses or lower infusion rates should be employed.
-
Eur J Anaesthesiol Suppl · Jan 1994
Randomized Controlled Trial Clinical TrialQuantitation of the interaction of rocuronium bromide with etomidate, fentanyl, midazolam, propofol, thiopentone, and isoflurane using closed-loop feedback control of infusion of rocuronium.
Sixty patients were randomly assigned to one of six groups (n = 10 in each case) in which anaesthesia was induced and maintained with etomidate, fentanyl, midazolam, propofol or with thiopentone and N2O, or isoflurane and N2O. After obtaining control measurements, rocuronium 0.6 mg kg-1 was given for intubation followed by an infusion, controlled by closed-loop feedback at 90% block. ⋯ The intravenous agents did not interact with recuronium to any clinically significant degree. Isoflurane reduced the requirements by 35-40%.
-
Eur J Anaesthesiol Suppl · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialComparison of haemodynamic effects of rocuronium bromide with those of vecuronium in patients undergoing CABG surgery.
In a double-blind study, cardiovascular parameters (cardiac output, heart rate, systolic and diastolic arterial pressure, pulmonary and systemic vascular resistances) were measured invasively in two groups of patients receiving 3 x ED90 of rocuronium or vecuronium. Measurements were made at 2, 5 and 7 min after administration and 10 and 15 min after subsequent intubation. Systemic vascular resistance mostly increased, sometimes quite markedly, although, because of the variability, rarely statistically significantly. However, heart rate, arterial pressure and cardiac output were not altered to a clinically relevant degree.
-
Eur J Anaesthesiol Suppl · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialRapid-sequence orotracheal intubation with rocuronium: a randomized double-blind comparison with suxamethonium--preliminary communication.
Eighty ASA I-III patients were randomly assigned to four groups. Group I patients received rocuronium 0.6 mg kg-1 immediately prior to thiopentone, while patients in group II received the same dose immediately after the induction agent. In groups III and IV a priming dose of rocuronium 0.04 mg kg-1 was administered prior to induction. ⋯ Priming with rocuronium did not improve intubation conditions. Total intubation scores > 6 occurred significantly more often in group II (P < 0.01 vs. all other groups). A single bolus dose of rocuronium 0.6 mg kg-1 (2 x ED95) administered immediately prior to thiopentone 6 mg kg-1 offers the same intubation conditions as suxamethonium 1.5 mg kg-1.
-
Eur J Anaesthesiol Suppl · Jan 1994
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialDose-response relationship of rocuronium bromide during intravenous anaesthesia.
The dose-response relationship and time course of neuromuscular block following bolus injections of rocuronium was determined in four groups of nine patients each under nitrous oxide-narcotic anaesthesia. Each patient received a total of 800 micrograms kg-1 rocuronium in two divided doses, i.e. 120 and 680, 200 and 600, 250 and 550, or 300 and 500 micrograms kg-1. The respective second dose was injected when, following the first dose, the evoked twitch tension had recovered to 95% of its control value. ⋯ The DUR25 ranged between 11 +/- 4 (200 micrograms kg-1) to 14 +/- 3 min (300 micrograms kg-1) following the first and from 30 +/- 6 (500 micrograms kg-1) to 43 +/- 11 min (680 micrograms kg-1) following the second doses. The recovery index following the second doses varied between 14 +/- 5 (500 micrograms kg-1) and 24 +/- 20 min (600 micrograms kg-1), more than twice as long as following the first doses. We conclude that rocuronium is a muscle relaxant of low potency with an intermediate duration of action.