Spontaneous Recovery Profile of Rapacuronium During Desflurane, Sevoflurane, or Propofol Anesthesia for Outpatient Laparoscopy

Zhou, Tian; Coloma, Margarita; White, Paul F.; Tang, Jun; Webb, Tom; Forestner, John E.; Greilich, Nancy B.; Duffy, Larry L.

doi:10.1213/00000539-200009000-00018

“…The spontaneous recovery to a train‐of‐four ratio of 0.7 in these studies increased significantly from 30 to 38 min to 54–57 min with these doses. The duration of action, measured to a train‐of‐four ratio of 0.7, is longer when anaesthesia is maintained with potent inhalational agents such as isoflurane, sevoflurane and desflurane, when this time may be approximately an hour or even longer [16–18].…”

Section: Basic Pharmacologymentioning

confidence: 99%

Rapacuronium: clinical pharmacology

Mirakhur

¹

,

McCourt

²

2001

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Summary The need for a rapid‐acting non‐depolarizing neuromuscular blocking agent with a short duration of action resulted in the synthesis of rapacuronium. The onset of maximum block with rapacuronium occurs in 60–90 s with doses of 1.5–2.5 mg kg−1 with a duration of clinical relaxation of 15–30 min. Rapacuronium provides clinically acceptable intubating conditions in 60 s in a majority of patients with these doses, although the conditions are somewhat inferior to those obtained with succinylcholine in lightly anaesthetized patients, such as those undergoing a rapid‐sequence induction. The main drawbacks of rapacuronium are the occurrence of dose‐related pulmonary side‐effects (increased airway pressure and/or overt bronchospasm) and hypotension and tachycardia. The cause of pulmonary side‐effects is not certain but these have been serious enough to make its worldwide introduction doubtful.

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“…Whether to use neuromuscular blocking agents or not depends on the patient factors, the type of anaesthetic that is planned, and the surgical procedure. However, specific surgical procedures, such as laparoscopic surgery, some ear, nose and throat procedures and microsurgery, require muscle relaxation [8].…”

Section: Introductionmentioning

confidence: 99%

“…Haemodynamic stability and a low incidence of histamine release are further requirements. From an economic point of view, a competitive price is another factor in the choice of relaxants in day case anaesthesia [8]. The agents fulfilling some of these requirements include succinylcholine, mivacurium, low‐dose intermediate‐acting agents, such as rocuronium, atracurium and vecuronium, and the recently introduced rapacuronium.…”

Section: Introductionmentioning

confidence: 99%

Muscle relaxants suitable for day case surgery

Geldner¹,

Wulf²

2001

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Neuromuscular blocking agents are used as adjuvants in day case anaesthesia to facilitate tracheal intubation and/or surgery. Although the majority of day case procedures are performed without the use of neuromuscular blocking agents, there are procedures, such as laparoscopic surgery, microsurgery, open eye surgery, some ear, nose and throat procedures and some paediatric procedures, which may require neuromuscular blockade. The characteristics of an ideal neuromuscular blocking agent for day case surgery are a short onset, a short clinical duration and a short recovery time, with or without reversal. It should also lack histamine release, provide haemodynamic stability, and be competitively priced. This paper reviews the neuromuscular blocking agents currently available and used, such as succinylcholine and mivacurium, low doses of an intermediate-acting neuromuscular block, such as rocuronium and the recently introduced rapacuronium. Their advantages and disadvantages are described and discussed, with special reference to the needs of day case surgery. Rapacuronium offers certain benefits compared with the currently available neuromuscular blocking agents for day care anaesthesia.

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“…However, specific surgical procedures, such as laparoscopic surgery, some ear, nose and throat procedures and microsurgery, require muscle relaxation [8]. However, specific surgical procedures, such as laparoscopic surgery, some ear, nose and throat procedures and microsurgery, require muscle relaxation [8].…”

Section: Introductionmentioning

confidence: 99%

“…From an economic point of view, a competitive price is another factor in the choice of relaxants in day case anaesthesia [8]. As day case procedures are generally short, the onset time of the agent used should be short (1-2 min) and as most day case procedures last about 30 min, duration of action should also be short, with or without antagonism.…”

Section: Introductionmentioning

confidence: 99%

Muscle relaxants suitable for day case surgery

Geldner

¹

,

Wulf

²

2001

European Journal of Anaesthesiology

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Neuromuscular blocking agents are used as adjuvants in day case anaesthesia to facilitate tracheal intubation and/or surgery. Although the majority of day case procedures are performed without the use of neuromuscular blocking agents, there are procedures, such as laparoscopic surgery, microsurgery, open eye surgery, some ear, nose and throat procedures and some paediatric procedures, which may require neuromuscular blockade. The characteristics of an ideal neuromuscular blocking agent for day case surgery are a short onset, a short clinical duration and a short recovery time, with or without reversal. It should also lack histamine release, provide haemodynamic stability, and be competitively priced. This paper reviews the neuromuscular blocking agents currently available and used, such as succinylcholine and mivacurium, low doses of an intermediate-acting neuromuscular block, such as rocuronium and the recently introduced rapacuronium. Their advantages and disadvantages are described and discussed, with special reference to the needs of day case surgery. Rapacuronium offers certain benefits compared with the currently available neuromuscular blocking agents for day care anaesthesia.

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Spontaneous Recovery Profile of Rapacuronium During Desflurane, Sevoflurane, or Propofol Anesthesia for Outpatient Laparoscopy

Cited by 13 publications

References 26 publications

Rapacuronium: clinical pharmacology

Rapacuronium: clinical pharmacology

Muscle relaxants suitable for day case surgery

Muscle relaxants suitable for day case surgery

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