scholarly journals COMPARISON OF HEMODYNAMIC AND NEUROMUSCULAR PROPERTIES OF ROCURONIUM VERSUS VECURONIUM IN ANESTHESIA

2021 ◽  
pp. 1-3
Author(s):  
Rajeev Krishan ◽  
Praveen Kumar Singh ◽  
Chandeshwar Choudhary ◽  
Debarshi Jana
Keyword(s):  
Blood Pressure ◽  
General Anesthesia ◽  
Onset Time ◽  
Cardiovascular Effects ◽  
Neuromuscular Blocking ◽  
Vecuronium Bromide ◽  
Rocuronium Bromide ◽  
Duration Of Action ◽  
Hemodynamic Variables ◽  
Significant Difference

Background: Adequate maintenance of airways in patients undergoing surgeries under general anesthesia was through proper intubation. This was achieved by the extensive usage of neuromuscular blocking drugs, which provided good intubation conditions and relaxation of the muscles. Neuromuscular blockers play a key role in general anesthesia. Rocuronium and vecuronium are used as nondepolarizing muscle relaxants. Objective: To study the neuromuscular properties and cardiovascular effects of rocuronium bromide, the “near-ideal” muscle relaxant and to compare it with vecuronium bromide, an already established drug, during anesthesia. Materials and Methods: This prospective, randomized double-blinded clinical study included 50 patients, 25 patients received 0.6 mg/kg of rocuronium bromide for the maintenance of anesthesia and the other 25 patients received 0.1 mg/kg of vecuronium bromide. The top-up doses administered were 0.15 mg/kg of rocuronium and 0.025 mg/kg of vecuronium. Result: The onset time was significantly shorter in the rocuronium group (Mean ± standard deviation [SD] was 108.8 s ± 28.875 s) compared with vecuronium group (Mean ± SD 188.76 s± 43.78 s). The duration of action of first dose was significantly longer in rocuronium group (31.5 min) compared with vecuronium group (24.5 min).The duration of action of top-up doses was similar in both the groups (p>0.05). There was no significant difference in any of the haemodynamic variables between the two groups. Conclusion: The duration of action of top-up doses was similar in both the groups (p > 0.05). There was no significant difference in any of the hemodynamic variables (heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure) between the two groups.

scholarly journals Effects of dexmedetomidine on the onset and duration of action in non-depolarizing neuromuscular relaxant rocuronium

2021 ◽  
Vol 19 ◽  
pp. 205873922110005
Author(s):  
Jiaqi Shan ◽  
Xiaofeng Wang ◽  
Xiaoli Zhang ◽  
Junfeng Zhang
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Anesthesia ◽  
Neuromuscular Blockade ◽  
Onset Time ◽  
Control Group ◽  
Monitoring Point ◽  
Obvious Effect ◽  
Duration Of Action ◽  
The Impact

To determine the impact of two varying doses of dexmedetomidine (DEX) on the onset and duration of neuromuscular blockade of rocuronium (ROC) under the condition of sevoflurane anesthesia. Eighty-one patients, American Society of Anesthesiologists Class I–II, were stochastically allocated to control group (group C) and two DEX groups (group D1 and group D2). In group D1 and group D2, DEX (0.5 and 1.0 µg/kg, respectively) was administrated 10 min before induction of general anesthesia. In group C, equivalent saline was infused by the same way. We monitored heart rate (HR), blood pressure, and train-of-four (TOF) values of all subjects in the period of anesthesia. We recorded times to reach TOF value 0 (T0, from injection of ROC to disappearance of all four twitches) as the onset time and TOF value 25% (T25, ratio of fourth twitch to first twitch,) as clinical duration of neuromuscular blockade. A total of 81 patients were randomized, 75 of whom accepted treatment, including group D1 ( n = 25), D2 ( n = 25), and C ( n = 25). T0 time of three groups was found to be similar. The duration of action for ROC in group D2 was 62.76 ± 6.33 min, which was much longer than that in group D1 and group C, which were 42.64 ± 3.92 and 42.56 ± 4.04 min ( p < 0.05), respectively. At T2 (after DEX administration) and T4 time point (10 min after trachea intubation), compared with group C, the changes of heart rate (HR) and blood pressure in DEX groups (group D1 and group D2) show greatly differences. Otherwise, there were no obvious differences among different groups at the other monitoring point-in-time. DEX infusion in general anesthesia has no obvious effect on the onset of ROC, but it is capable of prolonging its clinical effect time, which can provide reference for rational application of DEX and ROC in general anesthesia.

▾ Vecuronium - another intermediate duration neuromuscular blocking drug

1987 ◽  
Vol 25 (5) ◽  
pp. 19-20
Keyword(s):  
Histamine Release ◽  
Cardiovascular Effects ◽  
Neuromuscular Blocking ◽  
Vecuronium Bromide ◽  
Renal Elimination ◽  
Blocking Drug ◽  
Neuromuscular Blocking Drug ◽  
The Uk

Vecuronium bromide (Norcuron - Organon) is a neuromuscular blocking drug introduced in the UK shortly after atracurium besylate. The manufacturer claims it is free from significant unwanted cardiovascular effects, causes minimal histamine release and has low renal elimination and so does not cumulate.

scholarly journals Tai-chi-chuan and yoga onpostexercise hypotension: comparison to aerobic and resistance exercise

2016 ◽  
Vol 29 (3) ◽  
pp. 543-552
Author(s):  
João Douglas Alves ◽  
Jorge Luiz de Brito Gomes ◽  
Caio Victor Coutinho de Oliveira ◽  
José Victor de Miranda Henriques Alves ◽  
Fabiana Ranielle de Siqueira Nogueira ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Young Women ◽  
Tai Chi ◽  
Cardiovascular Effects ◽  
Cardiovascular Responses ◽  
Tai Chi Chuan ◽  
Post Exercise ◽  
Significant Difference ◽  
Apparently Healthy

Abstract Introduction: Tai-Chi-Chuan and Yoga have becoming popular practices. However is unclear the cardiovascular effects, and if they present similar behavior to aerobic and resistance sessions. Objective: To evaluate the cardiovascular responses during the session and post-exercise hypotension (PEH) of Tai Chi Chuan (TS) and Yoga (YS) in comparison to aerobic (AS) and resistance (SR) exercises. Methods: Fourteen young women (22.3 ± 2 years) apparently healthy performed four sessions (AS, RS, TS and YS). The heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP) were recorded at resting, during (every 10 minutes) and until 50 minutes of recovery. Results: AS, RS, TS e YS showed significant increase in HR compared to resting.AS at 10, 30 e 50 minutes in relation to RS, TS e YS. The RS in relation to TS and YS at 10, 30 and 50 minutes. No significant difference between TS and YS. SBP was significantly increased in AS, RS, TS e YS at 10, 30 e 50 minutes during the session, in relation to rest. AS was significantly higher at 30 e 50 minutes than RS and higher than TS and YS at 10, 30 e 50 minutes. No significant difference in DBP. For PEH, AS, RS and TS significantly reduced at 10, 30 and 50 minutes. YS reduced at 50 minutes. No significant diastolic PEH. Conclusion: TS and YS showed as safe alternatives of exercising in the normotensive young adult woman, despite having lower values, they promote similar hemodynamic behavior to AS and RS.

scholarly journals Effects of COX 1-2 Inhibitors on Prevention of Rocuronium Injection Pain: Controlled, Randomised, Double Blind Study

2021 ◽  
Author(s):  
Mehmet Sahap ◽  
Handan Gulec ◽  
Esra ozayar ◽  
Ozlem zdemir ◽  
Merve Kacan ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Control Group ◽  
Anesthesia Induction ◽  
Movement Response ◽  
Rocuronium Bromide ◽  
Cox Inhibitors ◽  
Significant Difference ◽  
Group 2 ◽  
Withdrawal Response ◽  
Group 1

Purpose : Rocuronium bromide is a painful agent while general anesthesia induction. The aim of the study is to investigate the effects of cox inhibitors as a resque agent against the rocuronium pain Methodology : Sixty patients enrolled for the general anesthesia enrolled in this study. Patients were allocated into two groups (Group 1: Dexkethoprofen group, Group 2: Control group) .Pain was evaluated by during rocuronium injection, patients were scored by a scale showed below. 0;No movement response to injection 1;Mild movement response to injection 2;Hand withdrawal response to injection 3;Arm withdrawal response to injection We also evaluated the pain with 2 questions when the patient was in the recovery room.Question 1.What was the last feeling before you fall into sleep? and question 2. Did you feel any pain on your hand during medication injection for anesthesia? Results:There were differences between the groups in terms of total pain score for example in group 1 there were 16 (53%) patients who did not make any movement during rocuronium injection while there were 22 (73%) patients in group 2.There was significant difference in injection rocuronium bromide pain between group 1: dexkethoprofen group, Group 2: control group in terms of the answer to the second question.Patients felt less pain than the control group. Conclusion:The effect of cox inhibitors on rocuronium pain was seen in our study but check is also effective in reducing pain in vascular width.

scholarly journals The effect of cold-chain re-introduction on the molecular integrity of rocuronium bromide

2021 ◽  
Author(s):  
D Vermeulen ◽  
M Wooding ◽  
K Outhoff ◽  
T Dippenaar
Keyword(s):  
Degradation Products ◽  
Rapid Sequence Induction ◽  
Vital Role ◽  
Cold Chain ◽  
Clinical Effects ◽  
Rocuronium Bromide ◽  
Onset Of Action ◽  
Duration Of Action ◽  
Significant Difference ◽  
Temperature Exposure

Introduction: This study aimed to examine the effect of breakages and re-introduction into cold chain on the rocuronium bromide compound. Rocuronium bromide is frequently used in routine theatre lists and plays a vital role in modified rapid sequence induction and intubation for emergency patients who have contraindications to the primarily used muscle relaxant, succinylcholine. With the current practice of removing the drug from, and then reintroducing it into the cold chain, unpredictable clinical effects, including delayed onset of action and shortened duration of action have been observed. This may pose significant risks to the patient. Methods: Rocuronium bromide was subjected to different clinically applicable storage and temperature scenarios, after which the compound was analysed for integrity and quantities of the active compound, including detection of possible degradation products, by mass spectrometry, and compared to cold chain control samples. Results: There were no significant differences between any of the temperature exposure groups (18 °C or 24 °C) or between single or double exposures at these temperatures. No statistically significant difference could be demonstrated between the two control groups (cold chain preserved and room temperature controlled) with testing done at weeks one and six. However, week twelve analysis revealed a statistically significant result which translates to a 26 μg/ml difference, which clinically would have no effect. Substantial results were obtained with a secondary exposure to air; which lead to a 20% decrease in rocuronium concentration (p = 0.02). Conclusion: Practice should be adapted by keeping careful documentation as to when cold-chain was broken, and when the recommended 12 week period will lapse. Vial sharing as a standard is not recommended. If small quantities are repeatedly withdrawn from the vial during a prolonged case, the unused contents should be discarded after eight hours.

Cardiopulmonary Effects of the Novel Neuromuscular Blocking Drug GW280430A (AV430A) in Dogs

2004 ◽  
Vol 100 (4) ◽  
pp. 846-851 ◽  
Author(s):  
Paul M. Heerdt ◽  
Richard Kang ◽  
Andrew The’ ◽  
Mir Hashim ◽  
Robert J. Mook ◽  
...  
Keyword(s):  
Cardiovascular Effects ◽  
Neuromuscular Blocking ◽  
Blocking Drug ◽  
Histamine Concentration ◽  
Duration Of Action ◽  
Neuromuscular Blocking Drug ◽  
Pulmonary Vasoconstriction ◽  
Arterial Blood ◽  
Before And After ◽  
Plasma Histamine Concentration

Background This investigation determined the cardiopulmonary side effects of a novel nondepolarizing neuromuscular blocking drug with an ultrashort duration of action in anesthetized male beagles. Methods The ED95 for GW280430A was first determined in four animals. These data were then used to guide bolus dosing in multiples of ED95 in six dogs instrumented for hemodynamic measurements as well as inspiratory pressure and pulmonary compliance. Cardiopulmonary data were compared before and after the conclusion of a 60- to 90-min GW280430A infusion and in response to subsequent incremental bolus dosing starting with 3.125 x ED95. An adverse response was regarded as an alteration of 10% or greater in any variable. Arterial blood was obtained for histamine analysis before and 1 min after each dose. Results The ED95 of GW280430A was 0.064 +/- 0.01 mg/kg, and stable neuromuscular blockade was maintained with infusion of 0.012 +/- 0.002 mg.kg(-1).min(-1). With the exception of a late 14% increase in heart rate, there were no cardiopulmonary changes during infusion. Bolus dosing produced no cardiopulmonary change until a decrease in mean arterial pressure was elicited in four of six dogs at 25 x ED95. This response was modest, transient, and associated with a concomitant increase in plasma histamine concentration. There were no accompanying changes indicative of direct myocardial depression, pulmonary vasoconstriction, or bronchospasm. Conclusions These data indicate that GW280430 does not produce demonstrable cardiovascular effects in the anesthetized dog until doses far in excess of the ED95 are administered as a bolus.

scholarly journals Comparison between the Effects of Thiopental Sodium and Propofol on Maternal Hemodynamics during Cesarean Section Under General Anesthesia and Apgar score of the newborns

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E Elshaer ◽  
H Omar ◽  
A Elshaer ◽  
T Youssif ◽  
W Abdelmoneim
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Well Being ◽  
Elective Cesarean Section ◽  
Anesthetic Drugs ◽  
Significant Difference ◽  
Thiopental Sodium

Abstract Background Cesarean delivery is one of the most current surgeries in women and one of the most significant challenges of anesthesiologists in this kind of surgery is the fetuses' exposure to anesthetic drugs. Regional anesthesia is generally preferred during cesarean section, but general anesthesia may be the only option under certain circumstances such as patient preference, back deformities. The most common drugs which are used in cesarean section to induce general anesthesia are thiopental sodium and propofol. Aim compare the effect of sodium thiopental induction versus propofol induction on hemodynamics of mothers undergoing elective cesarean section under general anesthesia and their effect on Apgar score of their newborns. Materials and Methods A total 260 healthy patients were included in an open randomized study, among whom 130 patients received Thiopentone and 130 received Propofol. These patients were premedicated with granisetron and ranitidine, after induction dose the maintenance was similar for both groups. APGAR scoring and umbilical cord venous gas analysis were among the parameters used for determining the general well-being of newborns. There were no significant difference between the two groups regarding Apgar scoring in 1st, 2nd and 5th minutes. Umbilical cord blood gas values were similar . There was no metabolic acidosis in newborns of mothers receiving thiopental or propofol as anesthetic agents during cesarean section. Results Group (T) received general anesthesia with thiopental at a dose of ( 4-6 mg/kg) while patients in group (P) received general anesthesia with propofol at a dose of (2mg/kg). As regards hemodynamic changes, there were no significant difference in maternal heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure during their measurement throughout the procedure-preoperatively, after delivery of the baby,15 minutes after delivery, after extubation and in recovery room- but after intubation, there were significantly lower in propofol group which suppressed hemodynamic response to intubation . Conclusion Thiopental and propofol can be safely used in cesarean sections, but the use of propofol is more advantageous than thiopental because it provides adequate anesthetic suppression of pressor response of intubation without any depressive effect on newborns.

scholarly journals Evaluation of cardiopulmonary parameters and recovery from anesthesia in cougars (Puma concolor) anesthetized with detomidine/ketamine and isoflurane or sevoflurane

2016 ◽  
Vol 36 (1) ◽  
pp. 33-38
Author(s):  
Verônica B. Albuquerque ◽  
Marcelo A. Araújo ◽  
Alice R. Oliveira ◽  
Guilherme Cavalcanti ◽  
Rodrigo C. Leal ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Blood Pressure ◽  
Puma Concolor ◽  
Venous Pressure ◽  
Onset Time ◽  
Abdominal Ultrasound ◽  
Anesthesia Induction ◽  
Arterial Blood ◽  
Significant Difference ◽  
Recovery From Anesthesia

Abstract: The aim of this study was to assess the cardiopulmonary effects, the onset time after the administration of a detomidine/ketamine combination, and the recovery from anesthesia of cougars (Puma concolor) anesthetized with detomidine/ketamine and isoflurane or sevoflurane for abdominal ultrasound imaging. Fourteen animals were randomly allocated into two experimental groups: GISO (n=7) and GSEVO (n=7). Chemical restraint was performed using 0.15mg/kg detomidine combined with 5mg/kg ketamine intramuscularly; anesthesia induction was achieved using 2mg/kg propofol intravenously and maintenance with isoflurane (GISO) or sevoflurane (GSEVO). The following parameters were assessed: heart rate, respiratory rate, systolic and diastolic arterial blood pressure, mean arterial blood pressure, oxyhemoglobin saturation, rectal temperature, central venous pressure, and end-tidal carbon dioxide. The time to sternal recumbency (TSR) and time to standing position (TSP) were also determined. There was not statistically significant difference for the cardiopulmonary variables or TSP whereas TSR was significantly shorter in GSEVO. The time to onset of anesthesia was 11.1±1.2 minutes and 11.3±1.8 minutes for GISO and GSEVO, respectively. The anesthesia of cougars with detomidine/ketamine and isoflurane or sevoflurane was conducted with safety, cardiopulmonary stability, and increased time to sternal recumbency in the GISO group.

General versus locoregional anesthesia in carotid surgery: A prospective randomised trial

VASA ◽  
2006 ◽  
Vol 35 (4) ◽  
pp. 232-238 ◽  
Author(s):  
Kasprzak ◽  
Altmeppen ◽  
Angerer ◽  
Mann ◽  
Mackh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
General Anesthesia ◽  
Carotid Endarterectomy ◽  
Randomised Trial ◽  
Complication Rates ◽  
Cardiopulmonary Complication ◽  
Locoregional Anesthesia ◽  
Significant Difference ◽  
Ica Stenosis

Background: To evaluate the influence of anesthetic technique on perioperative neurological and cardiopulmonary complication rates in patients undergoing carotid endarterectomy. Patients and methods: 186 patients with symptomatic internal carotid artery (ICA) stenosis > 70% or asymptomatic ICA stenosis > 80% were prospectively randomized for either locoregional (LA) or general anesthesia (GA). Results: Neurological complication rates were similar in both groups (GA 2% vs. LA 2%). Cardiopulmonary complication rates were not significantly different (GA 4% vs LA 1%).There were no stroke-related deaths, but one patient from the GA group died from severe postoperative pneumonia. Thus, a significant difference in combined stroke / cardiopulmonary related death between the two groups (GA 1% vs LA 0%) could not be found. However, perioperative cardiopulmonary monitoring showed that significantly more patients operated under general anesthesia had hypertensive events, with systolic blood pressure values greater than 180 mmHg on postoperative day one. There were no differences in the number of postoperatively hypotensive episodes (systolic blood pressure values < 100 mmHg) between the two groups. Conclusions: Significant differences in the perioperative neurological and cardiopulmonary complication rates between general and locoregional anesthesia in patients undergoing carotid endarterectomy could not be observed.

scholarly journals Remifentanil at induction of general anesthesia for cesarean section: Double blind, randomized clinical trial

2013 ◽  
pp. 87-91 ◽  
Author(s):  
Shokoufeh Behdad ◽  
Vida Ayatollahi ◽  
Hamid Harrazi ◽  
Naderali Nazemian ◽  
Najemh Heiranizadeh ◽  
...  
Keyword(s):  
Cesarean Section ◽  
General Anesthesia ◽  
Obstetric Anesthesia ◽  
Skin Incision ◽  
Assisted Ventilation ◽  
Elective Cesarean Section ◽  
Control Group ◽  
Double Blind ◽  
Duration Of Action ◽  
Hemodynamic Variables

Introduction: Remifentanil, with its rapid activity onset and short duration of action, may be more effective than other opioids for providing hemodynamic stability during obstetric anesthesia. However, there is some evidence of adverse effects on neonatal respiratory function. We investigated maternal and fetal effects of remifentanil during cesarean section surgery. Methods: Eighteen women with singleton term pregnancies, and physical class status of I or II as defined by the American Society of Anesthesia (ASA), who were undergoing general anesthesia for semi-elective cesarean section were randomized into two groups (40 in each group) that received either and intravenous bolus of 0.5 µg/kg remifentanil or the same dose of saline as a placebo. Maternal hemodynamic variables and neonatal umbilical artery pH and Apgar score at first and fifth min were evaluated in both groups. Results: Systolic and diastolic blood pressure were significantly lower after tracheal intubation and skin incision in the remifentanil group as compared with the control group (p<0.05). There were no significant differences regarding heart rate between groups at any time (p>0.05). Apgar scores at first and fifth min were not significantly different among groups (p>0.05). No neonate required assisted ventilation or naloxan administration. Conclusion: Remifentanil may be a safe and effective drug for the induction of general anesthesia and surgical stimulation without subsequent neonatal depression.

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