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

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

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: A priming dose of rocuronium can shorten the onset time of neuromuscular blockade. The purpose of this study was to evaluate the effect of priming with rocuronium on the onset time and intubation conditions during tracheal intubation with low-dose rocuronium (0.35 mg/kg) and to compare results with those for rocuronium 0.45 mg/kg. METHODS: One hundred twenty four patients were randomly allocated to three groups. Following induction of anesthesia, groups I and III received normal saline while group II received a priming dose of rocuronium (0.05 mg/kg). Three minutes after priming, groups I, II and III received, respectively, 0.45 mg/kg, 0.3 mg/kg and 0.35 mg/kg rocuronium. Intubation was performed 2 minutes after the administration of an intubating dose and intubation conditions were evaluated. Neuromuscular blockade was assessed by accelerography. RESULTS: The proportion of cases having optimal intubation conditions in group I was higher than in groups II and III. There was no significant difference in the onset times among groups. Neuromuscular blockade at 60, 90 and 120 seconds after an intubating dose was similar among all groups except at 60 sec. Maximal blockade for group I was deep compared to groups II and III. CONCLUSIONS: Rocuronium 0.35 mg/kg does not provide satisfactory intubation conditions. There are no effects on onset time and intubation conditions due to priming during tracheal intubation with rocuronium 0.35 mg/kg.
Androstanols ; Anesthesia ; Humans ; Intubation ; Intubation, Intratracheal ; Neuromuscular Blockade

BACKGROUND: To prevent sudden unexpected movement of patients during surgery, muscle relaxants are used to maintain intense neuromuscular blockade.They are administered by intermittent bolus or continuous infusion.Rocuronium is often used for continuous infusion because it is known to lack cumulative effects. The purpose of this study was to compare recovery times from intense neuromuscular block to reappearance of muscle twitches after 0.1 Hz single twitch stimulation. MATERIALS AND METHODS: Seventy five patients were randomized to one of 3 groups.Patients in group 1 were administered a single bolus of rocuronium; groups 2 and 3 were given continuous infusion of rocuronium for 1 and 2 h, respectively.During anesthesia, neuromuscular blockade was monitored by TOF-watch(R) and regulated so as not to exceed more than 5 (PTC) during the infusion. After infusion, PTC was counted every 5 min until single twitch heights had reappeared and the time till the twitch reappeared was calculated. RESULTS: There was a good correlation between the time it took to observe a PTC and the first response of TOF time in each group.In a parallelism test, there were no significant differences. There were also no significant differences in recovery times from PTC to the reappearance of a single twitch between groups. CONCLUSIONS: There are no significant differences in recovery times-from deep neuromuscular blockade to reappearance of single twitch-regardless of the infusion time.When a PTC occurs during deep neuromuscular blockade, it may predict the remaining time of reappearance of a single twitch response.
Androstanols ; Anesthesia ; Factor IX ; Humans ; Muscles ; Neuromuscular Blockade

A major goal in pharmacokinetic-pharmacodynamic (PK/PD) modeling of neuromuscular blockade (NMB) is to quantitatively estimate the dose-response relationship.Our PK/PD model consists of three submodels:PK, link kinetics, and PD.A virtual effect compartment in which the drug concentration is in equilibrium with the observed concentration is used to extract the kinetic component (keo) from the pharmacodynamic data alone.Parameters of this model are keo, Ce(50), and gamma.The underlying structural pharmacokinetics and pharmacodynamics for NMB have been well understood, and new novel PK/PD models have been substituted for the gold standard PK/PD model for NMB.The purpose of this review was to describe progress in the field of PK/PD modeling of NMB from the first model, a simultaneous PK/PD model developed by Sheiner et al in the 1970s, to some of the more complicated models.Specific PK/PD models, which accurately described the behaviors of rocuronium, mivacurium, atracurium, and cisatracurium, include the recirculatory model, the peripheral link model, the peripheral elimination model, and a nonparametric model for link kinetics.
Aluminum Hydroxide ; Androstanols ; Atracurium ; Carbonates ; Isoquinolines ; Kinetics ; Neuromuscular Blockade

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*