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

Schmidt, Joachim; Irouschek, Andrea; Muenster, Tino; Hemmerling, Thomas M.; Albrecht, Susanne

doi:10.1007/bf03018580

Cited by 20 publications

(21 citation statements)

References 16 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…to evaluate onset time and intubating conditions following rocuronium 0.6 mg/kg in adults patients anaesthetized with either propofol or thiopentone. The observation of Jaochim et al 7 correlated well with the present study in terms of TOF-ratio, which was around 0.57 and 0.54 at the time of successful intubation in group-II and group-III respectively.…”

Section: Discussionsupporting

confidence: 92%

“…They expressed their opinion that, when conducting studies of intubating conditions, only frequent-interval intubation attempts begun sufficiently early can development of optimum laryngeal conditions. This is particularly true for fast-acting muscle relaxants, such as rocuronium, where peripherally assessed onset of neuromuscular block can give no exact indication of moment when optimum laryngeal relaxation has first been achieved 7 . The use of repetitive intubation attempts to evaluate tracheal intubating conditions has been reported previously 14 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Study of Priming Technique of Rocuronium in Facilitating Intubation

Liaquatunnoor¹,

Yasmin

Khatun

2009

j Bangladesh Soc Anaesthesiologists

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

A Study of Priming Technique of Rocuronium in Facilitating Intubation

Liaquatunnoor¹,

Yasmin

Khatun

2009

j Bangladesh Soc Anaesthesiologists

View full text Add to dashboard Cite

show abstract

“…One study demonstrated a significant reduction in the onset times (74.0 vs. 44.7 s) for normal intubation doses of rocuronium (0.6 mg/kg) when primed with 0.06 mg/kg 3 min in advance. 182 When using a higher dose of rocuronium (1.0 mg/kg), another study showed equal onset times regardless of a priming dose. In the same study, patients with burn injuries also had similar onset times with or without precurarization, when the dose of rocuronium was increased to 1.5 mg/kg.…”

Section: Introductionmentioning

confidence: 99%

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Jensen

Callesen

Hagemo

et al. 2010

Acta Anaesthesiol Scand

115

View full text Add to dashboard Cite

Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high‐grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients should be given by, or under very close supervision by, experienced anaesthesiologists. Problems with the airway and the circulation must be anticipated. The risk of aspiration must be judged for each patient. Pre‐operative gastric emptying is rarely indicated. For pre‐oxygenation, either tidal volume breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre‐oxygenation in the obese patients should be performed in the head‐up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor influence on intubation conditions, and should be chosen on other grounds. Ketamine should be considered in haemodynamically compromised patients. Opioids may be used to reduce the stress response following intubation. For optimal intubation conditions, succinylcholine 1–1.5 mg/kg is preferred. Outside the operation room, rapid sequence intubation is also considered the safest method. For all patients, precautions to avoid aspiration and other complications must also be considered at the end of anaesthesia.

show abstract

“…A priming dose consisting of 10% of the intubation dose with a three to four minute priming interval has been considered reliable and effective. 5,11 Recently, priming doses of agents other than the non-depolarizing neuromuscular blocking agents have been used to benefit from their synergistic effects. 12,13 Rashkovsky et al suggested in their study on pancuronium and vecuronium that the formerly administered drug appeared to have a significant impact on both dose requirements and duration of action of the subsequent neuromuscular blocker.…”

Section: Discussionmentioning

confidence: 99%

“…3 Recent studies using non-depolarizing blocking agents for endotracheal intubation have reported different methods to shorten this period. 4,5 The "priming principle" is a recent commonly used approach to accelerate the effect of the basic drug by reducing the sensitivity of acetylcholine receptors by the administration of non-depolarizing blocking agents in sub-paralytic doses. This technique consists of the administration of a small dose of NMBA prior to the remaining dose.…”

mentioning

confidence: 99%

Comparison of Neuromuscular Blockade with Two Different Agents After A Priming Dose of Rocuronium: A Randomized Clinical Trial

Sen¹,

Güra²

2012

Turkiye Klinikleri J Med Sci

View full text Add to dashboard Cite

A AB BS ST TR RA AC CT T OOb bj je ec ct ti iv ve e: : The purpose of this study was to assess the pharmacological effects of a priming dose of rocuronium in combination with the non-depolarizing blockers rocuronium or vecuronium during the perioperative period. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Sixty patients with American Society of Anesthesiologists (ASA) risk status I or II scheduled to receive anesthesia for elective surgery were included in the study. Patients were randomly divided into four groups. Patients in Group I (n=15) received a priming dose of normal saline and rocuronium bromide 0.6 mg/kg following induction of anesthesia; patients in Group II (n=15) received a priming dose of normal saline and vecuronium bromide 0.1 mg/kg following induction; patients in Group III (n=15) received a priming dose of rocuronium bromide 0.1 mg/kg followed by rocuronium bromide 0.6 mg/kg after induction; and Group IV (n=15) patients received a priming dose of rocuronium bromide 0.1 mg/kg followed by vecuronium bromide 0,1 mg/kg. T95 (time to onset of action), T25 (clinical duration of action), T75 (total duration of action) and recovery index (RI) were measured and recorded. Patients were monitored for possible side effects. R Re es su ul lt ts s: : In Group III, in which patients were primed with rocuronium and maintained with rocuronium, the time to onset of action was significantly shorter than for patients in Group I. Similarly, this parameter was significantly shorter in Group IV patients than in Group II patients. T25 and T75 was significantly longer in Group II and Group IV than in the other groups. There was no significant difference in RI values between the groups. C Co on nc cl lu us si io on n: : Using rocuronium as a priming agent accelerates the neuromuscular blocking effects of both rocuronium and vecuronium and provides ideal intubation conditions when safe and quick intubation is required. K Ke ey y W Wo or rd ds s: : Neuromuscular blockade; rocuronium; vecuronium bromide Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, nondepolarizan nöromusküler bloker olarak rokuronyum ve vekuronyum kullanımı sırasında rokuronyumla başlangıç dozu uygulamasının perioperatif dönemdeki farmakolojik etkilerini araştırmaktır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Elektif cerrahi için anestezi alması planlanmış, American Society of Anesthesiologists (ASA) risk statüsüne göre grup I veya II'ye giren altmış hasta çalışmaya dahil edildi. Hastalar randomize olarak dört gruba ayrıldı. Grup I'deki hastalara (n= 15) serum fizyolojik ile başlangıç dozu, anestezi indüksiyonunu takiben rokuronyum bromid 0.6 mg/kg uygulandı; Grup II'deki hastalara (n= 15) serum fizyolojik ile başlangıç dozu, anestezi indüksiyonunu takiben vekuronyum bromid 0,1 mg/kg uygulandı; Grup III'teki hastalar (n= 15) rokuronyum bromid 0,1 mg/kg başlangıç dozunu takiben indüksiyonun ardından rokuronyum bromid 0,6 mg/kg dozunu aldılar ve Grup IV'teki hastalara (n= 15) rokuronyum bromid 0,1 mg/kg başlangıç dozunu takib...

show abstract

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

Abstract: P Pu ur rp po os se e: : Priming is a known technique to accelerate onset of neuromuscular blockade (NMB). Its effect on NMB of the larynx has not been studied yet.

Cited by 20 publications

References 16 publications

A Study of Priming Technique of Rocuronium in Facilitating Intubation

A Study of Priming Technique of Rocuronium in Facilitating Intubation

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

Comparison of Neuromuscular Blockade with Two Different Agents After A Priming Dose of Rocuronium: A Randomized Clinical Trial

Contact Info

Product

Resources

About