No abstract available.
Androstanols ; Humans ; Kidney Failure, Chronic

BACKGROUND: The aim of this study was to evaluate whether slow injection of diluted rocuronium could reduce rocuronium-induced withdrawal movements effectively in children. METHODS: After loss of consciousness, rocuronium 0.6 mg/kg was administered into 171 children according to the pre-assigned groups as follows: Group CF, injection of non-diluted rocuronium over 5 seconds; Group CS, injection of non-diluted rocuronium over 1 minute; Group DF, injection of diluted rocuronium (10 times) over 5 seconds; Group DS, injection of diluted rocuronium over 1 minute. An investigator who was blind to the injection techniques recorded patient movements followed by rocuronium injection. RESULTS: The incidence of withdrawal movement in Group CF was highest among the groups (all P < 0.0001). Moreover, withdrawal movement was less frequently observed in Group DS than in Groups CS and DF (P = 0.021 and P = 0.007, respectively). CONCLUSIONS: Slow injection of diluted rocuronium reduced the incidence of withdrawal movements in children.
Androstanols ; Child ; Humans ; Incidence ; Research Personnel ; Unconsciousness

33 patients were admitted to the clinical study with ASA class I or II. - Esmeron’s lag time was very short, 25.4 seconds and a rather strong maximum blockade, 98.6% after a quick onset time of 171 seconds. The recovery index was 14.4 minutes and the clinical duration was 33.8 minutes with a bolus dose of 0.6 mg/kg and 22.5 minutes with a maintenance dose 0.15 mg/kg
Cardiovascular Diseases ; Anesthesia ; Androstanols ; surgery ; Surgery, Oral

BACKGROUND:Intravenous injection of rocuronium produces intense discomfort at the site of injection in 50?80% of conscious patients.Many trials have sought to lessen the injection pain.The present study evaluated the incidence and severity of pain associated with intravenous injection of rocuronium in conscious patients, and determined the efficacy of different doses of 50 mg rocuronium diluted in 0.9% NaCl at minimizing injection pain. METHODS:Sixty healthy patients scheduled for general anesthesia were randomly divided into three groups (n = 20 each) for injection of 10 ml (NS 10), 20 ml (NS 20), or 40 ml (NS 40) of the NaCl-diluted rocuronium. Before induction, the incidence of pain was ascertained and its severity during subsequent rocuronium injection was classified as none, mild, moderate, severe, very severe. RESULTS:The incidence and the severity of pain were significantly lower in the NS 40 group than in the NS 10 group (P< 0.05). Pain severity was mild or absent for all NS 20 and NS 40 patients. CONCLUSIONS:Rocuronium diluted with NaCl effectively reduces injection pain in a dose dependent manner. s
Androstanols ; Anesthesia, General ; Humans ; Incidence ; Injections, Intravenous

BACKGROUND:Intravenous injection of rocuronium produces intense discomfort at the site of injection in 50?80% of conscious patients.Many trials have sought to lessen the injection pain.The present study evaluated the incidence and severity of pain associated with intravenous injection of rocuronium in conscious patients, and determined the efficacy of different doses of 50 mg rocuronium diluted in 0.9% NaCl at minimizing injection pain. METHODS:Sixty healthy patients scheduled for general anesthesia were randomly divided into three groups (n = 20 each) for injection of 10 ml (NS 10), 20 ml (NS 20), or 40 ml (NS 40) of the NaCl-diluted rocuronium. Before induction, the incidence of pain was ascertained and its severity during subsequent rocuronium injection was classified as none, mild, moderate, severe, very severe. RESULTS:The incidence and the severity of pain were significantly lower in the NS 40 group than in the NS 10 group (P< 0.05). Pain severity was mild or absent for all NS 20 and NS 40 patients. CONCLUSIONS:Rocuronium diluted with NaCl effectively reduces injection pain in a dose dependent manner. s
Androstanols ; Anesthesia, General ; Humans ; Incidence ; Injections, Intravenous

BACKGROUND: We designed this double-blind, placebo-controlled study to compare the efficacy of remifentanil in reducing the pain of both propofol and rocuronium injection during rapid-sequence induction. METHODS: Ninety-five patients, scheduled for elective surgery under general anesthesia, were divided into 3 groups: saline (Group S, n = 31), remifentanil 1 microg/kg (Group R, n = 32), and lidocaine 1.5 mg/kg (Group L, n = 32) were administered after tourniquet application. The occlusion was released after 1 min and 5 ml of 1% propofol was injected over 10 s. Pain on propofol injection was evaluated by a 10-point verbal numeric rating scale (VNRS). The rest of the induction dose of propofol and 1 mg/kg of rocuronium, were injected. Pain on rocuronium injection was evaluated by a four-point score (FPS). RESULTS: The VNRS of propofol injection was as follows: R (0.78) = L (1.34) < S (4.26). The incidence of withdrawal response due to rocuronium was as follows: R (6.3%) < L (53.1%) < S (83.9%). The FPS of rocuronium injection was as follows: R (0.81) < L (1.78) < S (2.93). CONCLUSIONS: Pretreatment with a bolus of remifentanil was effective in simultaneously reducing injection pain of propofol and rocuronium. In addition, remifentanil pretreatment was more effective in suppression of withdrawal response by rocuronium than lidocaine.
Androstanols ; Anesthesia, General ; Humans ; Incidence ; Lidocaine ; Piperidines ; Propofol ; Tourniquets

BACKGROUND: The effect-time data involves some pharmacokinetic (PK) information. Bragg model could derive the information from pharmacodynamic (PD) data alone. After administering rocuronium, we collected tension data without these plasma concentration values. We determined kinetic-pharmacodynamic (K-PD) parameters, simulated the predictions of effect-time relation at different amount of dose, and validated the calculated infusion rates (IR) by comparing with IR directly measured. METHODS: Thirteen dexterous male patients were given rocuronium 300microg/kg during propofol-fentanyl anesthesia. Twitch tensions of the right adductor pollicis in response to supramaximal single twitch stimulation every 10 seconds were measured until muscle paralysis recovered by 70 +/- 10% of control. The above data were fitted to Bragg equation, using Tablecurve3D(R). The parameters, k1, k2, IR50, and gamma, were derived with either individual regression or population regression. The correlations between individual parameter and time, the simulation, and validation by infusing rocuronium 3.66microg/kg/min were examined. RESULTS: Based on population regression, IR50 was 3.70microg/kg/min, gamma was 4.51, k1 (keo) was 0.71/min, and k2 (k10) was 0.022/min. The longer the duration of rocuronium action was, the smaller the values of IR50 and k2 were (correlation coefficient: -0.92, -0.61, respectively). ED50 calculated (= IR50/k2) was 168microg/kg. The effects of rocuronium 3.66microg/kg/min were estimated (45% by direct measurement, 49% by population parameters, and 21% by individual parameters). CONCLUSIONS: The results of infusion rate validation suggests that population parameters may better be applicable than individual post hoc parameters to predicting the clinically relevant effect-time relations.
Androstanols ; Anesthesia ; Humans ; Male ; Muscles ; Neuromuscular Blockade ; Paralysis ; Plasma

An ideal reversal agent could be given at any time after the administration of a neuromuscular blocking agent, and should have no muscarinic side-effects. Sugammadex is a modified gamma-cyclodextrin designed to encapsulate rocuronium bromide, providing a rapid reversal of neuromuscular blockade. Sugammadex is a revolutionary investigational reversal drug currently undergoing Phase III testing whose introduction into clinical practice in Korea may change the face of clinical neuromuscular pharmacology. The dose of sugammadex for reversal of moderate block (when T2 is detectable) is approximately 2 mg/kg, the dose is 4-8 mg/kg for profound block (post-tetanic count 1-2) and a larger dose of 16 mg/kg for immediate reversal. The use of sugammadex has not been reported to be associated with recurrence of block provided a dose that is adequate for reversal has been used. Sugammadex appears to have an acceptable safety profile. Volatile agent such as sevoflurane seems not to influence the sugammadex ability to reverse the rocuronium neuromuscular blockade.
Androstanols ; gamma-Cyclodextrins ; Korea ; Methyl Ethers ; Neuromuscular Blockade ; Recurrence

BACKGROUND: We have investigated the possibility of rocuronium 0.6 mg/kg and timing principle application with the same dose for rapid sequence induction (RSI) in 65 children, aged 4-8 yr. METHODS: Sixty five patients were randomly assigned to one of two groups; Group A (n = 31, timing principle application) received rocuronium (0.6 mg/kg) followed by administration of propofol (2.5 mg/kg), and group B (n = 36) received rocuronium (0.6 mg/kg) after administration of propofol. Intubation was assessed at 60 seconds just after administration of last injectants. Intubating conditions (jaw relaxation, vocal cord movement, and response to tracheal intubation) were evaluated as excellent, good, fair and poor. RESULTS: Excellent intubation conditions were obtained in 87% in group A and 61% in group B. However, clinically acceptable intubation conditions which means excellent and good did not show any significant difference as 100% (group A) and 99% (group B). CONCLUSIONS: In cases of pediatiric patients undergoing elective surgery, RSI was possible irrespective of the use of timing principle.
Aged ; Androstanols ; Child ; Humans ; Intubation ; Propofol ; Relaxation ; Vocal Cords

No abstract available.
Anaphylaxis* ; Androstanols ; Humans ; Neuromuscular Blockade* ; Neuromuscular Blocking Agents*