Time course of action and intubating conditions following vecuronium, rocuronium and mivacurium

Abstract

SummaryThe purpose of this study was to compare the time course of action and tracheal intubating conditions of vecuronium, rocuronium andmivacurium in anaesthetisedpatients. Anaesthesia consisted of thiopentone, fentanyl, N 2 0 / 0 2 and isoflurane. After a 2 x EDW dose thefrst attempt at tracheal intubation was made at 90s. Ifrequired, maintenance doses of 0.5 x EDw were administered.The intubating conditions after rocuronium were signiJicantly better than those after vecuronium and mivacurium. The average onset times of rocuronium (I 72 s) and vecuronium (I 92 s) were significantly shorter than that of mivacurium (229 s). The clinical duration and recovery time were significantly shorter after mivacurium (13 and 6min, respectively) than with vecuronium (33 and 14 rnin, respectivelys) and rocuronium (28 and 11 min, respectively). We conclude that rocuronium might be of advantage whenever the interval between the administration of the muscle relaxant and tracheal intubation must be short, whereas mivacurium may be of beneft i f fast spontaneous recovery is required.

Intubating conditions and blockade after mivacurium, rocuronium and their combination in young and elderly adults

“…The time chosen for this procedure appears rather arbitrary, as intervals varying between one minute and three minutes have been chosen by various investigators. 15,17,[19][20][21][22][23] It is expected that intubating conditions would have been less optimal if a shorter interval had been used. Conditions reported here might appear worse than in most published studies.…”

“…To obtain a fast onset, one could increase the dose of rocuronium to 0.9 mg·kg -1 , but the duration of action would be increased considerably. 19,20 Intubating conditions were assessed at 2.5 min in the present study. The time chosen for this procedure appears rather arbitrary, as intervals varying between one minute and three minutes have been chosen by various investigators.…”

A priming technique accelerates onset of neuromuscular blockade at the laryngeal adductor muscles

“…The onset time of rocuronium is significantly shorter than equivalent doses of any other non-depolarizing neuromuscular blocking agent. 2 Rocuronium 0.9 mg·kg -1 (3 × ED 95 ) was recommended as an alternative to succinylcholine for RSI in patients with contraindications to succinylcholine. 1 However, in comparison to rocuronium 0.6 mg·kg -1 , the recovery of neuromuscular transmission to 90% of control twitch height is increased from 45 min to 75 min at the adductor pollicis muscle (AP).…”

Pretreatment of rocuronium reduces the frequency and severity of etomidate-induced myoclonus

“…Frequency of myoclonus can be reduced by midazolam, etomidate, sufentanil, and remifentanil [4,13,14,16], but the effects of etomidate on myoclonus in patients pretreated with neuromuscular blocking agents have yet to be determined. The onset time of rocuronium is significantly shorter than equivalent doses of other neuromuscular blocking agents [23].…”