Pharmacokinetic studies of neuromuscular blocking agents: Good Clinical Research Practice (GCRP)

Viby‐Mogensen, J.; Østergaard, Doris; Donati, François; Fisher, Dennis M.; Hunter, Jennifer M.; Jp, Kampmann; Kopman, Aaron F.; Proost, Johannes; Rasmussen, S. N.; Skovgaard, L. T.; Varin, F.; Wright, P. M. C.

doi:10.1034/j.1399-6576.2000.441002.x

Cited by 46 publications

(26 citation statements)

References 79 publications

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“…Neuromuscular transmission monitoring complied with GCRP (good clinical research practice) 6,7 , using TOF-Watch ® SX (Organon) NMT monitor. After induction, but before administration of the neuromuscular blocking drug, the TOF-Watch ® SX NMT monitor was calibrated using its automatic start-up-procedure, and we then applied 0.1 Hz single twitch stimulation.…”

Section: Neuromuscular Monitoringmentioning

confidence: 99%

Influence of Gender on the Onset and Duration of Rocuronium-Induced Neuromuscular Block

Adamus¹,

Koutná²,

Gabrhelík³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims:To assess the infl uence of gender on the course of rocuronium-induced neuromuscular block following a single bolus dose of 2 × ED 95 (0.6 mg kg -1 ). Methods: Following the ethics committee approval and informed consent, 245 patients (121 men, 124 women) scheduled for elective general surgery under TIVA with muscle relaxation were studied. After rocuronium 0.6 mg kg -1 , the onset time for maximal depression of T 1 , clinical duration until 25 % recovery and recovery index (T 1 from 25 to 75 %) were determined with TOF-Watch ® SX accelerometric monitor. The data for male and female groups were compared with appropriate statistical tests (Student's unpaired t-test, Mann-Whitney Rank Sum Test and Fisher's exact test).Results: Men were signifi cantly larger (p < 0.001) and heavier (p < 0.05) than women, but the body mass index was comparable (ns). Conclusions: Women are more sensitive than men to the dose 0.6 mg kg -1 of rocuronium. Under the study conditions described, the onset time was shortened and the clinical duration increased in female patients. This suggests that the routine dose of rocuronium should be reduced in women.

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Section: Neuromuscular Monitoringmentioning

confidence: 99%

Influence of Gender on the Onset and Duration of Rocuronium-Induced Neuromuscular Block

Adamus¹,

Koutná²,

Gabrhelík³

et al. 2007

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Neuromuscular transmission monitoring complied with GCRP (good clinical research practice) 7,8 , using the NMT module of Datex-Ohmeda S/5™ Anaesthesia Monitor. Both oesophageal and skin temperature were Cisatracurium vs. rocuronium: a prospective, comparative, randomized study in adult patients under total intravenous anaesthesia continuously recorded.…”

Section: Neuromuscular Block and Monitoringmentioning

confidence: 99%

Cisatracurium vs. Rocuronium: A Prospective, Comparative, Randomized Study in Adult Patients Under Total Intravenous Anaesthesia

Adamus

Bělohlávek²,

Koutná³

et al. 2006

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Aims:To compare the pharmacodynamics of cisatracurium and rocuronium-induced neuromuscular block following single dose, allowing either spontaneous or neostigmine-accelerated complete recovery.Methods: Following the ethics committee approval and informed consent, 120 patients scheduled for elective surgery under TIVA with tracheal intubation were randomized into 4 groups with different cisatracurium (CIS, 0.10 or 0.15 mg.kg -1 ) or rocuronium (ROC, 0.60 or 0.90 mg.kg -1 ) doses administered. For each patient, the onset time for 95 % depression of T 1 , clinical duration until 25 % recovery, recovery index (T 1 from 25 to 75 %) and time from T 1 25 % to TOF-ratio 0.9 were determined allowing either spontaneous or induced recovery.Results: The onset times were 277 (SD 58), 220 (46), 91 (16) and 77 (16) s for the CIS 0.10, CIS 0.15, ROC 0.60 and ROC 0.90 groups (p < 0.05), respectively, with lower variability in both ROC groups (p < 0.05). The clinical durations were 42 (7), 52 (7), 35 (11) and 52 (12) min, respectively (p < 0.05 for lower doses). Recovery index was identical in all groups allowing either spontaneous recovery -15.9 (1.8), 15.5 (1.7), 16.1 (3.7) and 16.1 (4.0) min, or following neostigmine administration -4.4 (0.9), 4.5 (0.8), 4.3 (0.8) and 4.7 (0.7) min for respective groups. During spontaneous recovery, the variability of DUR25-TOF90 was twice as great for ROC than CIS groups (p < 0.05), while after neostigmine administration it was uniform in all groups.Conclusions: For equipotent doses, the onset times for CIS were approximately three times longer than for ROC. The average clinical duration for both relaxants ranged from 35 to 52 min with acceptable variability. Neostigmine administration accelerated the recovery and reduced its variability. When allowing for spontaneous recovery, less scatter was demonstrated for both CIS groups than for ROC ones.

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“…The evaluation included: 1) cisatracurium onset time (time interval [sec] between starting cisatracurium injection and obtaining ≥ 95% reduction in the amplitude response of adductor pollicis muscle); 2) clinical condition of tracheal intubation according to the scores proposed by Viby-Mogensen et al 2 , considering the following variables: diffi cult laryngoscopy (degree), vocal cords position, and reaction to tracheal tube insertion (Table 1) -intubation was considered acceptable when all variables were considered excellent or good and unacceptable when at least one variable was considered poor; 3 ) hemodynamic parameters (mean arterial pressure [MAP] and heart rate [HR]), measured immediately before anesthesia induction (T0), after anesthesia induction, before laryngoscopy and tracheal intubation (M1), and 1 minute after intubation (M2).…”

Section: Methodsmentioning

confidence: 99%

“…This time interval can be infl uenced by factors, such as hypnotics and those associated with neuromuscular block monitoring (e.g., time to muscle stabilization, control, and frequency of stimulation used) [1][2][3][4][5] . Among drugs used in anesthesia, some hypnotics have certain peculiarities and different mechanisms, with may interfere with muscle relaxation induced by nondepolarizing neuromuscular blockers (NDNMB) 5,[6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

Braga¹,

Braga²,

Potério³

et al. 2013

Rev. Bras. Anestesiol.

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Background and objective: Different drugs, including hypnotics, may infl uence the pharmacodynamic effects of neuromuscular blockers (NMB). The aim of this study was to evaluate the infl uence of propofol and etomidate on cisatracurium-induced neuromuscular blockade. Method: We included 60 patients, ASA I and II, undergoing elective surgery under general anesthesia in the study and randomly allocated them into two groups, according to their hypnotic drug: GI (propofol) and GII (etomidate). Patients received intramuscular (IM) midazolam (0.1 mg.kg ). The patients were ventilated with 100% oxygen until obtaining a reduction of 95% or more in the adductor pollicis response amplitude, with subsequent laryngoscopy and tracheal intubation. Neuromuscular function was monitored by acceleromyograhpy. We evaluated the onset of action of cisatracurium, tracheal intubation conditions, and hemodynamic repercussions. Results: The mean time and standard deviations of cisatracurium onset were: GI (86.6 ± 14.3 s) and GII (116.9 ± 11.6 s), with a signifi cant difference (p < 0, 0001). Intubation conditions were acceptable in 100% of GI and 53.3% of GII patients (p < 0.0001). Conclusion: Induction of neuromuscular blockade with cisatracurium was faster, with better intubation conditions in patients receiving propofol compared to those receiving etomidate, without hemodynamic repercussions.

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Pharmacokinetic studies of neuromuscular blocking agents: Good Clinical Research Practice (GCRP)

Cited by 46 publications

References 79 publications

Influence of Gender on the Onset and Duration of Rocuronium-Induced Neuromuscular Block

Influence of Gender on the Onset and Duration of Rocuronium-Induced Neuromuscular Block

Cisatracurium vs. Rocuronium: A Prospective, Comparative, Randomized Study in Adult Patients Under Total Intravenous Anaesthesia

Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

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