scholarly journals ROCURONIUM VERSUS CISATRACURIUM: INTUBATING CONDITIONS, EFFICACY, AND SAFETY.

2021 ◽  
pp. 8-11
Author(s):  
Deba Gopal Pathak ◽  
Poonam Sharma
Keyword(s):  
Histamine Release ◽  
General Anesthesia ◽  
Randomized Study ◽  
Rapid Onset ◽  
Rocuronium Bromide ◽  
Onset Of Action ◽  
Intubating Conditions ◽  
Arterial Blood ◽  
The Given ◽  
Cardiovascular Stability

Background: Neuromuscular blockers (NMB) are very important adjuvant to general anesthesia,Rocuronium bromide (aminosteroidal NMB) and cisatracurium besylate (benzylisoquinoline NMB) are recently introduced non-depolarizing muscle relaxants.In a prospective randomized study,we had compared both the drugs as regard to the onset of action, intubating conditions,clinical duration,hemodynamic changes,and adverse effects. Method: 80 female patients ASA I&II,18-60 year old underwent elective abdominal surgery under general anesthesia (GA) were randomly assigned into 2 equal groups.ROC group,where 0.9mg/kg rocuronium was given and CIS group, where 0.15mg/kg cisatracurium was given. Standardized GA was given to all patients as follows, fentanyl 1mcg/kg, propofol 2mg/kg,intubation was tried by the same anesthetist who was blind to the given NMB after 60 sec of injection, intubation was done if the intubating condition was acceptable (excellent or good),and it was re-attempted every 30 sec if it was poor or inadequate.Anesthesia was maintained by 60% N2O in O2 and isoflurane to a total MAC 1.5,controlled ventilation was adjusted to normocapnia.Mean arterial blood pressure (MAP),heart rate,and intubating conditions were recorded. Results: Clinically acceptable intubating conditions were achieved after 60 sec more frequently with rocuronium (80%) than with cisatracurium(0%).Rocuronium had advantage of rapid onset of action with good intubating conditions as compared to Cisatracurium and both were found to be potent and safe with excellent cardiovascular stability and also without any apparent histamine release. Conclusion: Rocuronium has a rapid onset of action with good intubating conditions in comparison to cisatracurium both are potent and safe with excellent cardiovascular stability and do not cause apparent histamine release

scholarly journals Non-Traditional Administration of Remifentanil in an Experimental Setting

2019 ◽  
pp. S97-S103
Author(s):  
A. KURZOVÁ ◽  
J. MÁLEK ◽  
L. HESS ◽  
M. JAČEK ◽  
J. SLÍVA
Keyword(s):  
Arterial Oxygen Saturation ◽  
Pharmacokinetic Profile ◽  
Rapid Onset ◽  
Arterial Oxygen ◽  
Onset Of Action ◽  
Routes Of Administration ◽  
Arterial Blood ◽  
Pharmacokinetic Properties ◽  
Righting Reflex ◽  
Cardiovascular Functions

Remifentanil is ultrashort-acting opioid with a unique pharmacokinetic profile. It is used exclusively intravenously. While considering its rapid onset of action and other pharmacokinetic properties, we decided to assess its effects following administration via non-traditional routes. Rabbits (n=10 per each group) were randomized into six groups: remifentanil 1 μg/kg and 3 μg/kg IM, 5.0 and 10.0 μg/kg conjunctivally, and 10 μg/kg and 25.0 μg/kg intranasally. Sedating effects were assessed via a loss of the righting reflex. Secondary, mean arterial blood pressure, arterial oxygen saturation of hemoglobin, and pulse rate was monitored in all rabbits. Non-traditional routes of administration were shown to provide a rapid onset of action as well as fast recovery. Importantly, the administration of remifentanil did not result in any deterioration of cardiovascular functions.

scholarly journals Evaluation of lumbo-sacral epidural anaesthesia or analgesia with lidocaine-acepromazine combination in dogs undergoing cystotomy

2020 ◽  
Vol 6 (6) ◽  
pp. 204
Author(s):  
Abubakar S. Yakubu ◽  
Abidoye O. Ebenezer ◽  
Aisha A. Abdulkareem ◽  
David A. Adedokun ◽  
Adamu A. Abubakar ◽  
...  
Keyword(s):  
Epidural Anaesthesia ◽  
Complete Blood Count ◽  
Rapid Onset ◽  
Anesthetic Techniques ◽  
Epidural Administration ◽  
Onset Of Action ◽  
Regional Analgesia ◽  
Oxygen Saturation Level ◽  
Arterial Blood ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Epidural anaesthesia is one of the most frequently used regional anesthetic techniques recommended for surgical procedures caudal to the umbilicus in dogs. However, the use of lignocaine alone for epidural regional analgesia has been discovered to have shorter duration of analgesia and prolong onset of action, hence there is need to explore combinations of agents that will overcome this challenge. This study aimed to evaluate the anaesthetic/analgesic effect of cranial epidural anaesthesia in dogs undergoing cystotomy using Lignocaine in combination with acepromazine at the dose rates of 7 mg/kg and 0.05 mg/kg respectively.</p><p class="abstract"><strong>Methods:</strong> Eight apparently healthy matured, male and female dogs were used for the experiment. The onset and duration of analgesia was determined. The pulse rates, respiratory rates, mean arterial blood pressure, rectal temperature, complete blood count and the oxygen saturation level were determined at baseline, intra operative and post-operative.  </p><p class="abstract"><strong>Results:</strong> There were no significant differences in all the parameters measured before and after the epidural administration of the agents. The onset of anaesthesia was rapid and the duration of anaesthesia was sufficient enough for the procedure to be carried out. However, there was significant difference in PCV, Hb and total RBC count between the baseline and other timing intervals. There were no significant differences in leucocytic and cardiopulmonary parameters between the baseline and other timing intervals.</p><p class="abstract"><strong>Conclusions:</strong> The epidural administration of lignocaine and acepromazine combination at the doses indicated can produced sufficient epidural anaesthesia with rapid onset for the purpose of cystotomy in dogs without major systemic influence on hemodynamic and cardiopulmonary changes.</p>

Pharmacokinetic peculiarities of drugs used in the form of rapidly dispersible tablets (oral delivery system)

2020 ◽  
pp. 7-24
Author(s):  
Zhanna Kozlova ◽  
Ivan Krasnyuk ◽  
Yuliya Lebedeva ◽  
Ekaterina Odintsova
Keyword(s):  
Oral Mucosa ◽  
Oral Delivery ◽  
Chemical Properties ◽  
Rapid Onset ◽  
Systemic Circulation ◽  
Systemic Delivery ◽  
Onset Of Action ◽  
Mucosal Drug Delivery ◽  
Physical And Chemical ◽  
Pass Metabolism

Oral mucosal drug delivery is an alternative method of systemic delivery with several advantages over both injectable and enteral methods. Drugs that are absorbed through the oral mucosa directly enter the systemic circulation, passing through the gastrointestinal tract and first-pass metabolism in the liver due to oral mucosa being highly vascularised. This results in rapid onset of action for some drugs because of a more comfortable and convenient way of delivery than the intravenous one. But not all drugs can be administered through the oral mucosa due to characteristics of the oral mucosa and physical and chemical properties of the drug.

A Review on Enteric Coated Pellets Composed of Core Pellets Prepared by Extrusion-Spheronization

2019 ◽  
Vol 13 (2) ◽  
pp. 83-90 ◽  
Author(s):  
Hetal Patel ◽  
Mukesh Gohel
Keyword(s):  
Dosage Form ◽  
Extended Release ◽  
Rapid Onset ◽  
Enteric Coating ◽  
Onset Of Action ◽  
The Core ◽  
Current State ◽  
Enteric Coated ◽  
Extrusion Spheronization ◽  
Acid Labile

Enteric coated dosage form bypasses the stomach and releases the drug into the small intestine. Advantages of enteric coated pellets in comparison with enteric coated tablets are a) Pellets provide rapid onset of action and faster drug release due to the smaller size than tablets and b) Pellets exhibit less residence time of acid-labile drugs in the stomach compared to tablets. Dosage form coat can be damaged by longer resistance time in the stomach. The present review summarizes the current state of enteric coated pellets where core pellets are prepared by extrusion-spheronization technique and the enteric coating is applied in a fluidized bed processor. Two approaches are involved in the preparation of core pellets. In the first approach, a mixture of drug and excipient(s)/co-processed excipient is passed through extruders to prepare core pellets. In the second approach, excipient core pellets are prepared by extrusion technique and the drug is layered onto it before the enteric coating. The excipients present in the core pellets decide immediate or extended release of drug in the intestine. The coprocessed excipient pellets provide less batch variability and provide a platform for layering of many drugs before enteric coating. Some patents included enteric coating pellets [CN105456223 (A), CN105596310 (A), CN105616371 (A), CN105663095 (A), CN101611766B, CN106511862 (A), CN106668018 (A), CN106727381 (A), CN106924222 (A), TW200624127 (A), US 2017/0165248A1, US 2017/0224720A1] are discussed.

scholarly journals Nasal Delivery of Acute Medications for Migraine: The Upper Versus Lower Nasal Space

2021 ◽  
Vol 10 (11) ◽  
pp. 2468
Author(s):  
Vincent Martin ◽  
John Hoekman ◽  
Sheena K. Aurora ◽  
Stephen B. Shrewsbury
Keyword(s):  
Acute Treatment ◽  
Drug Efficacy ◽  
Hepatic Metabolism ◽  
Rapid Onset ◽  
Systemic Circulation ◽  
Nasal Delivery ◽  
Attractive Alternative ◽  
Gi Tract ◽  
Onset Of Action ◽  
First Pass

The acute treatment of migraine requires effective drugs that are well tolerated and provide rapid and consistent pain relief. Oral tablets are the most commonly used acute treatment for migraine; however, their effectiveness is limited by the rate of gastrointestinal (GI) tract absorption and first-pass hepatic metabolism, and they may not be ideal for patients experiencing GI motility issues. Nasal delivery is an attractive alternative route as it may circumvent GI tract absorption, avoid first-pass metabolism in the liver, and potentially reduce the frequency of GI adverse events. The large surface area and high vascularity within the nose may permit rapid absorption of therapeutics into the systemic circulation, allowing for rapid onset of action. However, the site of drug deposition (upper versus lower nasal cavity) may influence drug pharmacokinetics. Most approved nasal migraine therapies target the lower nasal space where the epithelium is less permeable, and they may be quickly cleared away due to increased ciliary function or dripping from the nose or swallowing, resulting in variable absorption and limited bioavailability. Together with its abundant vascularization, relative mucosal thickness stability, and low clearance rates, the upper nasal space harnesses the benefits of nasal delivery to potentially maximize drug efficacy.

Terlipressin Versus  Norepinephrine to Correct Refractory Arterial Hypotension after General Anesthesia in Patients Chronically Treated with Renin-Angiotensin System Inhibitors

2003 ◽  
Vol 98 (6) ◽  
pp. 1338-1344 ◽  
Author(s):  
Gilles Boccara ◽  
Alexandre Ouattara ◽  
Gilles Godet ◽  
Eric Dufresne ◽  
Michèle Bertrand ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Arterial Blood Pressure ◽  
Renin Angiotensin System ◽  
Arterial Hypotension ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Arterial Blood ◽  
Long Term Treatment ◽  
Systolic Arterial Blood Pressure

Background Terlipressin, a precursor that is metabolized to lysine-vasopressin, has been proposed as a drug for treatment of intraoperative arterial hypotension refractory to ephedrine in patients who have received long-term treatment with renin-angiotensin system inhibitors. The authors compared the effectiveness of terlipressin and norepinephrine to correct hypotension in these patients. Methods Among 42 patients scheduled for elective carotid endarterectomy, 20 had arterial hypotension following general anesthesia that was refractory to ephedrine. These patients were the basis of the study. After randomization, they received either 1 mg intravenous terlipressin (n = 10) or norepinephrine infusion (n = 10). Beat-by-beat recordings of systolic arterial blood pressure and heart rate were stored on a computer. The intraoperative maximum and minimum values of blood pressure and heart rate, and the time spent with systolic arterial blood pressure below 90 mmHg and above 160 mmHg, were used as indices of hemodynamic stability. Data are expressed as median (95% confidence interval). Results Terlipressin and norepinephrine corrected arterial hypotension in all cases. However, time spent with systolic arterial blood pressure below 90 mmHg was less in the terlipressin group (0 s [0-120 s] vs. 510 s [120-1011 s]; P &lt; 0.001). Nonresponse to treatment (defined as three boluses of terlipressin or three changes in norepinephrine infusion) occurred in zero and eight cases (P &lt; 0.05), respectively. Conclusions In patients who received long-term treatment with renin-angiotensin system inhibitors, intraoperative refractory arterial hypotension was corrected with both terlipressin and norepinephrine. However, terlipressin was more rapidly effective for maintaining normal systolic arterial blood pressure during general anesthesia.

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