Neuromuscular Effects of Rocuronium on the Diaphragm and Adductor Pollicis Muscles in Anesthetized Patients

Cantineau, J. P.; Porte, F.; Honneur, Gilles D; Duvaldestin, P.

doi:10.1097/00132586-199504000-00037

Cited by 26 publications

(46 citation statements)

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“…Onset and recovery profiles of blockade are generally faster at central muscles but less intense for a given dose than peripheral muscles. 1,[8][9][10][11] In contrast to other central muscles, the masseter muscle is relatively more sensitive to neuromuscular blocking drugs (NMBD) demonstrated using mechanomyography or acceleromyography. [2][3][4][5] Whether the faster and more pronounced blockade of masseter muscle is due to a greater sensitivity and/or it is from a faster equilibration rate compared to the adductor pollicis muscle, has not been well established with formal pharmacokinetic-pharmacodynamic (PKPD) methods.…”

Section: Editorial Comment: What This Article Tells Usmentioning

confidence: 99%

“…1,[8][9][10][11] In contrast to other central muscles, the masseter muscle is relatively more sensitive to neuromuscular blocking drugs (NMBD) demonstrated using mechanomyography or acceleromyography. 1,[8][9][10][11] In contrast to other central muscles, the masseter muscle is relatively more sensitive to neuromuscular blocking drugs (NMBD) demonstrated using mechanomyography or acceleromyography.…”

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confidence: 99%

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Rocuronium pharmacokinetics and pharmacodynamics in the adductor pollicis and masseter muscles

Vega

Ibacache

Anderson

et al. 2016

Acta Anaesthesiol Scand

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Section: Editorial Comment: What This Article Tells Usmentioning

confidence: 99%

mentioning

confidence: 99%

Rocuronium pharmacokinetics and pharmacodynamics in the adductor pollicis and masseter muscles

Vega

Ibacache

Anderson

et al. 2016

Acta Anaesthesiol Scand

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“…end their manuscript with the problem of neuromuscular monitoring at the adductor pollicis muscle after injection of rocuronium. In particular they wrote: ‘This muscle might not be a good predictor of concurrent optimal intubating conditions’[9]. We conclude from our results that rocuronium has a rapid onset of action, in particular at the masseter muscle.…”

Section: Discussionmentioning

confidence: 70%

The onset of neuromuscular block at the masseter muscle as a predictor of optimal intubating conditions with rocuronium

et al. 1999

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After an intubating dose of rocuronium satisfactory intubating conditions are achieved before the onset time at the adductor pollicis. We examined the possibility that measurement of the relaxation of the masseter muscle is a more appropriate guide when determining the intubating time. Simultaneous accelerometry with a 0.1-Hz single twitch stimulation of the chin and thumb was performed in 20 patients after 0.6 mg kg-1 rocuronium. We observed a significantly more brief mean lag time and onset time at the masseter muscle (22.5 and 61 vs. 32.5 and 160 s). The corresponding mean relaxation at the onset time was also significantly more pronounced at the masseter muscle (99.6 vs. 97.6%). A mean onset time at the masseter muscle of 61 s as produced by rocuronium corresponds clinically with excellent or good intubating conditions. From these results, we suggest that measurement of the onset time of muscle relaxation at the masseter muscle appears to be a better predictor of good intubating conditions than measurements made using the adductor pollicis muscle after administration of rocuronium.

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“…[1819] The laryngeal muscles have a faster onset and early recovery compared to AP with neuromuscular blocking drugs. [20] Monitoring the onset of neuromuscular block in the CS can predict the presence of good or excellent intubating conditions earlier than the use of AP.…”

Section: Discussionmentioning

confidence: 99%

Comparison of effect of ephedrine and priming on the onset time of vecuronium

Anandan

Suseela

Purayil³

2017

Anesth Essays Res

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Background:Succinylcholine has been the neuromuscular blocking drug of choice for laryngoscopy and intubation, but it has several adverse effects. Nondepolarizing neuromuscular blocking drugs are good alternative provided their onset of action is hastened. Priming technique and use of ephedrine or MgSO4 pretreatment is good options.Aims:To compare the effects of priming and ephedrine pretreatment on the onset time of intubating dose of vecuronium.Settings and Design:A prospective, randomized comparative study was done at a state-owned tertiary care teaching hospital.Materials and Methods:After obtaining the Institutional Ethical Committee approval and written informed consent, sixty patients of either gender aged 18–60 years, the American Society of Anesthesiologists physical status Class I/II, weighing 40–70 kg, were randomly divided into two groups of thirty each. Group E received 70 μg/kg ephedrine, and Group P received 0.01 mg/kg of vecuronium 3 min before intubating dose of vecuronium. Intubation was done after getting a train of four zero. Intubation time, clinical intubation grade using Cooper's scale, and hemodynamic parameters were noted.Statistical Analysis Used:Chi-square test and independent t-test were done with PASW statistics 18 to analyze data.Results:The mean time for intubation in ephedrine group (E) was 104 ± 23.282 s and in the priming group (P), it was 142 ± 55.671 s (P = 0.001). All patients had clinically acceptable intubating conditions, and the grades were comparable among groups (P = 0.791). Hemodynamic parameters were comparable between groups at all time frames (P > 0.05).Conclusion:Pretreatment with ephedrine 70 μg/kg shortens the onset time of vecuronium for intubation and is superior to the priming technique. Low-dose ephedrine, when used along with propofol induction, provides hemodynamic stability during induction and intubation.

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Neuromuscular Effects of Rocuronium on the Diaphragm and Adductor Pollicis Muscles in Anesthetized Patients

Cited by 26 publications

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Rocuronium pharmacokinetics and pharmacodynamics in the adductor pollicis and masseter muscles

Rocuronium pharmacokinetics and pharmacodynamics in the adductor pollicis and masseter muscles

The onset of neuromuscular block at the masseter muscle as a predictor of optimal intubating conditions with rocuronium

Comparison of effect of ephedrine and priming on the onset time of vecuronium

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