The effects of nicardipine or esmolol on the onset time of rocuronium and intubation conditions during rapid sequence induction: a randomized double-blind trial

Lee, Ji Heui; Kim, Yunkwang; Lee, Kye Hyeok; Rim, Sung Kyu; Lee, Ji Yeon; Lee, Cheong

doi:10.1007/s00540-014-1940-5

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Esmolol: This selective beta blocker has negative inotropic and chronotropic effects. Combining this drug with NMBDs may delay the onset of action [ 35 ].…”

Section: Factors That Affect Onset Timementioning

confidence: 99%

Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

Kim

Sung

Yang

2017

Korean J Anesthesiol

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Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action. Factors that affect the onset time include the potency of the NMBDs, the rate of NMBDs reaching the effect site, the onset time by dose control, metabolism and elimination of NMBDs, buffered diffusion to the effect site, nicotinic acetylcholine receptor subunit affinity, drugs that affect acetylcholine (ACh) production and release at the neuromuscular junction, drugs that inhibit plasma cholinesterase, presynaptic receptors responsible for ACh release at the neuromuscular junction, anesthetics or drugs that affect muscle contractility, site and methods for monitoring neuromuscular function, individual variability, and coexisting disease. NMBDs with rapid onset without major adverse events are expected in the next few years, and the development of lower potency NMBDs will continue. Anesthesiologists should be aware of the use of NMBDs in the management of anesthesia. The choice of NMBD and determination of the appropriate dosage to modulate neuromuscular blockade characteristics such as onset time and duration of neuromuscular blockade should be considered along with factors that affect the effects of the NMBDs. In this review, we discuss the factors that affect the onset time of NMBDs.

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“…Esmolol: This selective beta blocker has negative inotropic and chronotropic effects. Combining this drug with NMBDs may delay the onset of action [ 35 ].…”

Section: Factors That Affect Onset Timementioning

confidence: 99%

Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

Kim

Sung

Yang

2017

Korean J Anesthesiol

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“…This is not desirable in a rapid sequence intubation scenario where we want good relaxation and that too quickly. Lee et al [19] have shown that nicardipine hastens the onset of action as compared to esmolol.…”

Section: Discussionmentioning

confidence: 99%

Effect of Labetalol and Esmolol on Onset of Action of Rocuronium: A Prospective Double-Blinded Randomized Controlled Trial

Acharya

Mishra

Rath

et al. 2018

Asian J Pharm Clin Res

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Objective: Labetalol is a non-selective beta blocker which is used for the treatment of hypertension. Its role in controlling the hemodynamic response to tracheal intubation is established. This comparative controlled study was carried out to verify its effects on time to onset of action of rocuronium in comparison to esmolol. Methods:We randomized patients into two groups. Group A receiving injection labetalol 0.25 mg/kg diluted to 10 ml with 0.9% saline and Group B receiving 0.5 mg/kg of esmolol in 10 ml 0.9% saline before surgery. The time to onset of action of rocuronium, systolic blood pressure, and heart rate were recorded. The adverse reactions were observed in the post-operative period.Results: A total of 60 patients were randomized into two groups. At the time of intubation, the systolic blood pressure and heart rate were similar between the two groups. The onset of action of rocuronium was decreased significantly in the labetalol group. Conclusion:Labetalol attenuates the hemodynamic response to tracheal intubation both during intubation. It also slightly decreases the time to onset of action of rocuronium.

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“…Efe ve arkadaşlarının 19 yapmış olduğu çalışmada ise esmolol infüzyonu bolus esmolol uygulaması ile karşılaştırılmış ve infüzyon olarak uygulanan esmololun entübasyon ve sternotomi sırasında sistolik arteriyel kan basıncını kontrol etmekte daha etkin olduğu gösterilmiştir. Bunun yanı sıra esmololün hızlı seri entübasyondan sonra kalp hızı yanıtını baskılamasına rağmen roküronyumun etki başlangıcını bozabileceği ve dolayısıyla entübasyonu olumsuz etkileyebileceği de belirtilmiştir 20 .…”

Section: Bulgularunclassified

Altmışbeş yaş üzeri hastalarda tek doz esmolol’ün desfluran ve sevofluran anestezisinde trakeal entübasyona yanıt ve bispektral indeks üzerine etkisi

Uçak¹,

Güneş²,

Biricik³

et al. 2017

Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi)

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ARAŞTIRMA / RESEARCH Altmışbeş yaş üzeri hastalarda tek doz esmolol'ün desfluran ve sevofluran anestezisinde trakeal entübasyona yanıt ve bispektral indeks üzerine etkisiEffect of single dose of esmolol on response to endotracheal intubation and bispectral index during sevoflurane and desflurane anesthesia in patients over 65 years Abstract Öz Purpose: In this prospective, randomized study, we aimed to compare the effects of single dose of esmolol on haemodynamic, bispectral index (BIS) changes related to intubation and recovery at sevoflurane and desflurane anaesthesia in 65 years and older patients who scheduled for elective surgery Material and Methods: Eighty ASA II-III patients who undergo elective surgery were divided 4 groups. After standart and Bispectral monitoring to all patients, the first group received sevoflurane and salin,e second group received desflurane and salin. The patients in Group III received sevoflurane and single dose of esmolol(1 mg kg-1) and group IV received desflurane and single dose of esmolol(1 mg kg-1). While given induction drugs, neuromuscular blockers, during intubation and at 30 second, first minute and 5. minutes of intubation, oxygen saturation, systolic and diastolic blood pressure, heart rate, BIS values were recorded. Results: Single dose of esmolol administration during sevoflurane and desflurane anaesthesia was found to inhibit the increase of BIS values due to endotracheal intubation. When the groups compared, extubation, eyeopening and recovery time were significantly shorter in the groups which applied esmolol. Conclusion: In elderly patients, single dose esmolol administration in desflurane and sevoflurane anesthesia significantly inhibits sympathetic decharge and BIS value increases due to tracheal intubation.Amaç: Bu prospektif ve randomize çalışma, elektif cerrahi geçirecek 65 yaş ve üzeri ASA II-III hastalarda, sevofluran ve desfluran anestezisinde tek doz uygulanacak esmololün hemodinamik değişiklikler, entübasyona bağlı Bispektral indeks (BIS) değişiklikleri ve derlenme üzerine etkilerini karşılaştırmayı amaçlamaktadır. Gereç ve Yöntem: 65 yaş üzeri ASA II-III elektif cerrahi geçirecek 80 hasta 4 gruba ayrıldı. Tüm hastalara standart monitörizasyon ve BIS monitörizasyonu uygulandıktan sonra Grup I deki hastalara sevofluran ve intravenöz(IV) salin, Grup II deki hastalara desfluran ve IV salin, Grup III deki hastalara sevofluran ve tek doz esmolol (1 mg kg-1), Grup IV deki hastalara desfluran ve tek doz esmolol (1 mg kg-1) uygulandı. Hastaların indüksiyon ajan uygulanması sonrası, esmolol uygulanması sonrası, kas gevşetici uygulanması sonrası, entübasyon esnasında, entübasyon sonrası oksijen saturasyonu, sistolik kan basıncı, diyastolik kan basıncı, kalp atım hızı ve bispektral indeks değerleri kaydedildi. Bulgular: Tek doz esmolol uygulamasının sevofluran ve desfluran anestezisinde endotrakeal entübasyona bağlı BIS değerlerindeki artışı engellediği görüldü. Gruplar karşılaştırıldığında esmolol uygulanan gruplarda ekstübasyon, göz açma ve derlenme süreleri daha ...

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The effects of nicardipine or esmolol on the onset time of rocuronium and intubation conditions during rapid sequence induction: a randomized double-blind trial

Cited by 7 publications

References 20 publications

Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents

Effect of Labetalol and Esmolol on Onset of Action of Rocuronium: A Prospective Double-Blinded Randomized Controlled Trial

Altmışbeş yaş üzeri hastalarda tek doz esmolol’ün desfluran ve sevofluran anestezisinde trakeal entübasyona yanıt ve bispektral indeks üzerine etkisi

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