Onset time and duration of rocuronium effect in patients undergoing renal transplantation
| Autor: | Vianna, Pedro Thadeu Galvão [UNESP], Takata, I. H. [UNESP], Braz, José Reinaldo Cerqueira [UNESP], Castiglia, Yara Marcondes Machado [UNESP], Ganem, Eliana Marisa [UNESP], De Carvalho, L. R. [UNESP] |
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| Přispěvatelé: | Universidade Estadual Paulista (Unesp) |
| Jazyk: | portugalština |
| Rok vydání: | 2000 |
| Předmět: |
anesthesia induction
clinical article Rocuronium [Neuromuscular Blockers Nondepolarizing] adult drug effect etomidate central venous catheter kidney transplantation alfentanil rocuronium Renal transplantation [Surgery Urologic] Acceleromyography [Monitoring neuromuscular] anesthesia level female neuromuscular blocking midazolam male anesthetic recovery dose response drug blood level heart rate mean arterial pressure controlled study human endotracheal intubation |
| Zdroj: | Scopus Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
| Popis: | Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:19:52Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:29:16Z : No. of bitstreams: 1 2-s2.0-0034023808.pdf: 175258 bytes, checksum: ff183cbd792e43386349bb1f4df89cce (MD5) Made available in DSpace on 2014-05-27T11:19:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2000-01-01 Background and Objectives - Successful cadaver kidney transplantation relies on a fast procedure. Patients with chronic renal failure may present with a delayed gastric emptying making it critical a fast tracheal intubation and airway maintenance. Rocuronium a recently introduced nondepolarizing neuromuscular blocker with a fast onset. The aim of this study was to evaluate onset time and duration of rocuronium effects in patients undergoing renal transplantation. Methods - Sixty patients were allocated into two groups of 30: Group R (GR) = patients undergoing renal transplantation and Group N (GN) = patients with normal renal function. All patients were premedicated with oral midazolam (15 mg) and anesthesia was induced with 30 μg.kg-1 alfentanil, 0.3 mg.kg-1 etomidate and 0.6 mg.kg-1 rocuronium injected through a central venous catheter. neuromuscular block was monitored by acceleromyography in the ulnar nerve pathway. The following parameters were evaluated: time between administration of rocuronium and first twitch reduction to 5% after supra-maximal stimulation (T1) (onset time = OT); time for first twitch to return to 25% (clinical duration = R25); time elapsed between 25% and 75% recovery of first twitch (relaxation recovery time = R25-75). Heart rate (HR) and mean blood pressure (MBP) were recorded in 6 moments. Results - Median OT was 31 sec. in GR and 47 sec. in GN. Median R25 was 51.5 min in GR and 33.5 min in GN. Median R25-75 was 28 min in GR and 20 min in GN. MBP and HR were higher in GR. Tracheal intubation conditions were excellent for most patients in both groups. Conclusions - These results open the possibility of 0.6 mg.kg-1 rocuronium being injected through a central venous catheter when a faster onset is needed. Due to wide differences in individual responses, monitoring of neuromuscular block is recommended. Departamento de Anestesiologia FMB-UNESP, Distrito de Rubiao Junior, 18618-970 Botucatu, SP Departamento de Anestesiologia FMB-UNESP, Distrito de Rubiao Junior, 18618-970 Botucatu, SP |
| Databáze: | OpenAIRE |
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