Time Course of Neuromuscular Block of Vecuronium Analogues and d-Tubocurarine in the Chick Biventer Cervicis Muscle

1995 ◽  
pp. 365-365
Author(s):  
Joanna M. Ward ◽  
Hassan Fajrak ◽  
Chris Prior
Keyword(s):  
Time Course ◽  
Neuromuscular Block ◽  
Chick Biventer Cervicis Muscle

Onset and Duration of Rocuronium-induced Meeting Abstracts in Patients with Duchenne Muscular Dystrophy

2005 ◽  
Vol 102 (5) ◽  
pp. 915-919 ◽  
Author(s):  
Stefanie Wick ◽  
Tino Muenster ◽  
Joachim Schmidt ◽  
Juergen Forst ◽  
Hubert J. Schmitt
Keyword(s):  
Single Dose ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Time Course ◽  
Spontaneous Recovery ◽  
Standard Dose ◽  
Neuromuscular Block ◽  
Peak Effect ◽  
Surprising Result ◽  
Time To Peak

Background In patients with Duchenne muscular dystrophy (DMD) the response to nondepolarizing muscle relaxants is scarcely documented and conflicting. The current study was conducted to determine the time to peak effect and the time for complete spontaneous recovery after a single dose of 0.6 mg/kg of rocuronium in patients with DMD. Methods Twenty-four patients (12 with DMD, 12 controls, aged 10-16 yr) were studied. All patients were anesthetized with propofol and fentanyl/remifentanil. Neuromuscular transmission was monitored by acceleromyography. After induction all patients received a single dose of 0.6 mg/kg of rocuronium. The complete time course of onset and spontaneous recovery were recorded Results Significant (P < 0.01) increase in the onset times to 95% neuromuscular block was observed in DMD patients (median, 203 s; range, 90-420 s) compared with controls (median, 90 s; range, 60-195 s). The time between rocuronium administration and recovery of first twitch of the train-of-four to 90% was significantly (P < 0.01) prolonged in DMD compared with controls (median, 132 min; range, 61-209 min versus 39 min; 22-55 min). The recovery index was also significantly prolonged in the DMD group compared with controls (median, 28 min, range, 15-70 min versus 8 min; 3-14 min). Conclusions The most striking and surprising result of this study is the delayed onset of blockade in DMD after a standard dose of rocuronium. This effect should be kept in mind in situations when a rapid airway protection is necessary in DMD patients. The documented very long recovery from rocuronium-induced block emphasizes the need for careful assessment of neuromuscular function in DMD patients.

The Influence of Mild Hypothermia on the Pharmacokinetics and Time Course of Action of Neostigmine in Anesthetized Volunteers

2002 ◽  
Vol 97 (1) ◽  
pp. 90-95 ◽  
Author(s):  
Tom Heier ◽  
David Clough ◽  
Peter M. C. Wright ◽  
Manohar L. Sharma ◽  
Daniel I. Sessler ◽  
...  
Keyword(s):  
Time Course ◽  
Mechanical Response ◽  
Mild Hypothermia ◽  
Neuromuscular Block ◽  
Onset Time ◽  
Volume Of Distribution ◽  
Maximum Effect ◽  
Surface Cooling ◽  
Duration Of Action ◽  
Course Of Action

Background The pharmacokinetics, maximum effect, and time course of action of neostigmine were studied in seven human volunteers. Methods Each volunteer was studied twice, during both normothermia and hypothermia. Anesthesia was induced with 30 microg/kg alfentanil and 3 mg/kg propofol, and was maintained with 60-70% nitrous oxide and 0.7-0.9% isoflurane. The mechanical response of the adductor pollicis to train-of-four stimulation of the ulnar nerve was recorded, and central body temperature maintained stable at either less than 34.5 degrees C or greater than 36.5 degrees C by surface cooling or warming. Before neostigmine administration, a stable 5% twitch height was obtained by an infusion of vecuronium, and the infusion rate remained unchanged thereafter. Neostigmine, 70 microg/kg, was then infused over 2 min, and blood samples for estimation of neostigmine concentrations were collected at intervals for 240 min. Results With hypothermia, the central volume of distribution of neostigmine decreased by 38%, and onset time of maximum effect increased (4.6 vs. 5.6 min). Hypothermia did not change the clearance (696 ml/min), maximum effect, or duration of action of neostigmine. Conclusions The efficacy of neostigmine as an antagonist of vecuronium-induced neuromuscular block is not altered by mild hypothermia.

scholarly journals Neuromuscular block in patients 80 years and older: a prospective, controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Denis Schmartz ◽  
Raouf Sghaier ◽  
Paul Bernard ◽  
Jean François Fils ◽  
Thomas Fuchs-Buder
Keyword(s):  
Time Course ◽  
Neuromuscular Block ◽  
Demographic Data ◽  
Onset Time ◽  
Rapid Onset ◽  
Controlled Study ◽  
Younger Adults ◽  
Number Of Patients ◽  
Long Acting ◽  
Prospective Controlled Study

Abstract Background An increasing number of patients older than 80 years are undergoing anesthesia, but little information is available regarding pharmacodynamic effects of myorelaxants in this population. This study aims to compare the time course of rocuronium neuromuscular block in patients ≥ 80 years with those of younger adults. Methods Under total intravenous anesthesia with propofol and sufentanil, time course of a bolus of rocuronium 0.6 mg/kg neuromuscular block was assessed with acceleromyography in patients ≥ 80 and in patients 20–50 years old. Onset time, clinical duration, duration until 90% and 100% recovery of baseline were determined. Results Data from 32 patients were analyzed, 16 were ≥ 80 years and 16 were 20–50 years old. Demographic data are shown in Table 1. In the group ≥ 80, onset time was 190 s ± 46 s compared to 123 s ± 40 s in the group 20–50, P < 0.001 and the clinical duration was 52 [48–69.5] min and 36 [34–41] min, respectively, P < 0.001. Duration to 90% recovery of baseline was 77.5 [71–88.5] min and duration to 100% recovery of baseline was 91.2 [82.2–98] min in patients ≥ 80 years and the corresponding values in the patients 20–50 years old were 53.5 [49–55.5] min and 59.5 [56.5–70.25] min, respectively, P < 0.001. Conclusion Compared to younger adults rocuronium shifted in patients ≥ 80 years from a rapid onset, intermediate acting compound to a slower onset, long-acting compound. Trial registration ClinicalTrials.gov identifier: NCT03551652 (29/05/2018).

Dose-Response of Rocuronium Bromide in Children Anesthetized with Propofol 

1997 ◽  
Vol 87 (6) ◽  
pp. 1368-1372 ◽  
Author(s):  
Rex L. Woolf ◽  
Mark W. Crawford ◽  
Shu May Choo
Keyword(s):  
Dose Response ◽  
Time Course ◽  
Neuromuscular Block ◽  
Linear Regression Analysis ◽  
Rapid Onset ◽  
Rocuronium Bromide ◽  
Response Data ◽  
Course Of Action ◽  
Recovery Profile ◽  
Supramaximal Stimulation

Background The aim of this study was to determine the potency of rocuronium during propofol/fentanyl/N2O anesthesia in children and to compare the time course of action of rocuronium at doses of two and three times the ED95 with that of succinylcholine. Methods Rocuronium (120, 160, 200, or 240 microg/kg) was administered to 48 children aged 2-10 yr. Neuromuscular block was assessed by monitoring the electromyographic response of the adductor digiti minimi to supramaximal stimulation of the ulnar nerve at 2 Hz for 2 s every 10 s. Potency was determined by log-probit transformation and least-squares linear regression analysis of dose and response. In a second group of 30 children, the onset and recovery profile of rocuronium at doses of two and three times the ED95 was compared with that of succinylcholine (2 mg/kg). Results Values for ED50 and ED95 were 210 +/- 24 and 404 +/- 135 microg/kg, respectively. The time to 90% neuromuscular block after 1.2 mg/kg rocuronium (three times the ED95), 33 +/- 5 s (mean +/- SD), did not differ significantly from that after succinylcholine, at 30 +/- 7 s; however, both were significantly less than that after 0.8 mg/kg rocuronium, 46 +/- 8 s (P &lt; 0.05). The time to 25% recovery from 1.2 microg/kg rocuronium, 41 +/- 13 min, was approximately 50% greater than that after 0.8 mg/kg, at 27 +/- 6 min (P &lt; 0.001), and eight times greater than that after succinylcholine, at 5.2 +/- 1.9 min (P &lt; 0.001). Conclusions Both 1.2 mg/kg rocuronium (three times the ED95) and 2 mg/kg succinylcholine provide 90% neuromuscular block within 45 s in 95% of children. The present dose-response data support the use of rocuronium at a dose of 1.2 mg/kg when rapid onset and intermediate-duration neuromuscular block are needed in children.

FACTORS DETERMINING THE TIME COURSE OF THE NEUROMUSCULAR BLOCK IN HUMANS

1992 ◽  
Vol 77 (Supplement) ◽  
pp. A915
Author(s):  
M. Banoub ◽  
V. Nigrovic
Keyword(s):  
Time Course ◽  
Neuromuscular Block

scholarly journals FACTORS AFFECTING MAGNITUDE AND TIME COURSE OF NEUROMUSCULAR BLOCK PRODUCED BY SUXAMETHONIUM

1992 ◽  
Vol 69 (1) ◽  
pp. 29-35 ◽  
Author(s):  
L.E.H. VANLINTHOUT ◽  
J. VAN EGMOND ◽  
T. DE BOO ◽  
J.G.C. LEROU ◽  
R.A. WEVERS ◽  
...  
Keyword(s):  
Time Course ◽  
Neuromuscular Block ◽  
Factors Affecting

Contractile speed and EMG changes during fatigue of sustained maximal voluntary contractions

1983 ◽  
Vol 50 (1) ◽  
pp. 313-324 ◽  
Author(s):  
B. Bigland-Ritchie ◽  
R. Johansson ◽  
O. C. Lippold ◽  
J. J. Woods
Keyword(s):  
Nerve Stimulation ◽  
Maximal Voluntary Contraction ◽  
Time Course ◽  
Muscle Activation ◽  
Neuromuscular Block ◽  
Voluntary Contraction ◽  
Percentage Change ◽  
Electromyographic Activity ◽  
Excitation Rate ◽  
Voluntary Contractions

Measurements were made from the human adductor pollicis muscle of force, contractile speed, and electromyographic activity (EMG) before, during, and after maximal isometric voluntary contractions sustained for 60 s. The use of brief test periods of maximal nerve stimulation with single shocks or trains of shocks enabled various muscle mechanical properties to be studied throughout each contraction. Electrical activity was measured after rectification and smoothing of the surface potentials and also by counting the total number of potentials per unit time from a population of motor units using fine wire intramuscular electrodes. During a 60-s maximal voluntary contraction, the force fell by 30-50%. Throughout the experiment the voluntary force matched that produced by supramaximal tetanic nerve stimulation. This indicated that, with sufficient practice, full muscle activation could be maintained by voluntary effort. However, the amplitude of the smoothed, rectifed EMG and the rate of spike counts declined. Since no evidence for neuromuscular block was found, the decline in EMG and spike counts was attributed to a progressive reduction of the neural drive from the central nervous system, despite maintained maximum effort. After the prolonged voluntary contractions twitch duration was prolonged, mainly as a result of slowing in relaxation rate. Twitch summation in unfused tetani increased. Both the maximum rate of relaxation and the time course of force decay declined by 50-70%. Similar changes were seen in both voluntary contractions and in test periods of stimulation. The percentage change in muscle contractile speed measured by these parameters approximately equaled the percentage change in the surface EMG measured simultaneously. It is concluded that 1) during a 60-s sustained maximal voluntary contraction there is a progressive slowing of contraction speed such that the excitation rate required to give maximal force generation is reduced, 2) the simultaneous decline in EMG may be due to a continuous reduction in motoneuron discharge rate, and 3) the EMG decline may not necessarily contribute to force loss.

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